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Permit Number <4 Z3 Q2
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Phone Number
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Type of Occupancy
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BIB 2 5/90
ELEVATION CERTIFICATE O.M.B. No 3067-0077
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro-
vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine
the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not
required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form.
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME
—I POLICY NUMBER
STREET ADDRESS (Including Apt.. Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER C PANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
Lot 28, Block B Amending Plat of The Peninsulas of Coppell
CITY
STATE ZIP CODE
Coppell Texas
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER
480170
2. PANEL NUMBER
0010
3. SUFFIX
E
4. DATE OF FIRM INDEX
4-15-94
5. FIRM ZONE
X
6. BASE FLOOD ELEVATION
(in AO Zones, use CepM)
453.0
PUKaie me elevation oatum system used on the FIRM for Base Flood Elevations (BFE): K NGVD '29 ❑ Other (describe on back)
2 For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE: ! ! feet NGVD (or other FIRM datum -see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1 Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level .
2(a). FIRM Znnes Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of 141517 ,(6J reet NGVD (or other FIRM datum -see Section B, Item 7). _
(b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of I , ' .' feet NGVD (or other FIRM datum -see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is Lam. feet above or
below ❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is L__L.) .'J feet above ❑ or below ❑ (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: L] NGVD '29 ❑ Other (describe
under Comments on Page 2). (NOTE. If the elevation datum used in measuring the elevations is different than that used on
the FIRM [see Section B, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
a Elevation reference mark used appears on FIRM: __ Yes _XNo (See Instructions on Page 4)
5 The reference level elevation is based on: XJ actual construction J construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate
will be required once construction is complete.)
The elevation of the lowest grade immediately adjacent to the building is: L-"4 1516 1.0 feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C. Item 1
s not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: _ . _ feet NGVD (or other FIRM datum -see Section B, Item 7).
2 Date of the start of construction or substantial improvement _
FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones Al -A30, AE, AH, A (with BFE),V1-V30,VE, and V (with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
l certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the data available.
If understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME
TITLE
ADD-- R. .
RESS
7104
SIGNATURE
Copies st
OF
row A",cP
LICENSE NUMBER (or Affix Seal)
# 1994
< .
S14 . COMPANY NAME
,,�
• ...::•••-••• ...............:J.:...•. arrow Surveying Company
W. OAHIMUVV_
.:............................. CITY
STATE ZIP
ra vine "° ls9 rth Worth Texas 76118
DATE PHONE
April 6 1998 (817)268-0200
Id ma a of this Ce J�
fiir: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS: The Elevations hereon were taken from a Form Board Survey
There is no actual structure existing on this property. The FIRM
for the City of Coppell has been amending by letter from from the
_Federal Emer encs Management Agency Case NO 94-06-105A This property
is now located in Zone "X" Map shows Zone "AE".
ON
wrrm
sue ON �.
BASEMENT PIERS, OR COLuMNS
A
ZONES ZONES ZONES
ZONES ZONES
REFERENCE REFERENCE
LEVEL BASE LEVEL
REFERENCE
FLOOD
LEVEL
ELEVATION
,,..
BASE
FLOOD ADJACENT �' REFERENCE
ELEVATION REFERENCE ADJACENT GRADE LEVEL
BASE
FLOOD
ELEVATpN
LEvE: GRADE
...`
...: ADJACENT `.
GRADE
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal
structural member
Page 2