FEMA-EC040115FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
Q,M,B, No, 3067-0077
Expires December 31 , 2005
ELEVATION CERTIFICATE
Important Read the instructions on paoes 1 .7.
SECTION;". PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
HOLMES BUILDERS
BUILDING STREET ADDRESS (Induding Apt, Un" Su,e, and/or Bldg, No,) OR PO, ROUTE AND BOX NO, Company NAIC Number
304 BETHEL ROAD
CITY STATE ZIP CODE
COPPELL 1)( 7501 9
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 1R, BLOCK 1 BETHEL ROAD ESTATES, PHASE II
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type):_
0_##'_##,##"
or ##,_~ DNAD1927 DNAD1983 o USGS Quad Map o Other:
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1, NFIP COMMUNITY NAME & COMMUNITY NUMBER
COPPELL 480170
B2, COUNTY NAME
DALLAS
B3. STATE
TX
84, Ml\P AND PANEL B7 FIRM PANEL 89, BASE FLOOD ELEVA TION(S)
NUMBER B5, SUFFIX B6, FIRM INDEX DATE EFFECTIVEflEVISED DATE 88, FLOOD ZONE(S) (Zone AO, use depth of flooding)
48113C0135 J 8I23l2OO1 XAE 494.5
B10, Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9,
o FIS Profile 121 FIRM 0 Community Determined 0 Other (Describe):_
B11, Indicate the elevation datum used tor the BFE in B9: 121 NGVD 1929 0 NAVD 1988 0 Other (Describe):_
B12, Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes 121 No Desl9nation Dale
SECTION C" BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1, Building elevations are based on: 0 Construction Drawings' 121 Building Under Construction' 0 Finished Construction
A new Elevation Certificale will be required when construction of Ihe building is complete,
C2, Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram
accurately represents the building, provide a sketch or photograph,)
C3. Elevations-Zones A1-A30, AE, AH, A (wilh BFE), VE, V1-V30, V (l'ith BFE), AR. ARJA, ARJAE, ARJA1-A30, ARJAH, ARJAO
Compete Items C3.-aj below according to the building diagram spectfied in Item C2, State the datum used, If the datum is different from the dalum used for the BFE In
Section B, convert the datum to that used for the BFE, Show field measurements and datum conversion calculation, Use the space provided or the Comments area of
Section 0 or Section G, as appropriate, to document the datum conversion,
Datum NGVD 1929 Conversion/Comments BM PROVIDED BY ENGiNEERJSURVEYOR
Elevation reference mark used _Does the elevation reference mark used appear on the FIRM? 0 Yes 121 No
o a) Top of bottom loor (induding basement orendosure) 504, 35 ft,(m)
o b) Top of next higher floor NA,_ft,(m)
o c) Bottom of lowest horizontal structural member (V zones only) NA, _ft,(m)
o d) Attaohed garage (top of slab) NA, _ft,(m)
o e) Lowest elevation of machinery andlor equipment
servicing the building (Describe in a Comments area) NA, _ft,(m)
o D Lowest adjacent (finished) grade (LAG) 503, 03 ft,(m)
o g) Highest adjacenl(finished) grade (HAG) 503. 50 ft,(m)
o h) No, of permanent openings (flood vents) within 1 ft, above adjacent grade NA
o i) Total area of all permanent openings (flood vents) in C3,h NA sq in, (sq, em)
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SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information,
certify that the information in Sections A, S, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punIshable by fine or imprisonment under 18 US, Code, Section 1001,
CERTIFIER'S NAME BARRY RHODES LICENSE NUMBER 3691
TITLEOWNER COMPANY NAME BARRY RHODES LAND SURVEYING
ADDRESS
7509PENNRIDGE CIRCLE
SIGNATURE
CI1Y
ROWLETT
DATE
1/15/2004
STATE
TX
TELEPHONE
972475-8940
ZIP CODE
75088
FEMA Form 81.31, January 2003 See reverse side for continuation Replaces all previous editions
IMPORT ANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
BUILDING STREET ADDRESS (Indudirg Apt, Un~ Sure, andlC>' BIdg, No,) OR P,O, ROUTE AND BOX NO, Polk:y Number
304 BETHEL ROAD
CITY STATE ZIP CODE Company NAIC Number
COPPELL TX 75019
SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) communijy official, (2) Insurance agenVcompany, and (3) building owner.
COMMENTS
o Check here if attachments
SECTION E. BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4, If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed,
El, Building Di"ilram Number _(S~ect the building diagram most SImilar to the building for which this certificate is oong completed - see pages 6 and 7, If no diagram accurateiy
represents the building, provide a sketch or photograph,)
E2, The top of the bottom ftoar (including basement or enciosure) of the building is _ ft,(m) _in,(cm) 0 aoove or 0 beiow (check one) the highest adjacent grade, (Use
natural grade, if availa~e),
E3 For Building Diagrams !Xl with openings (see P"ile 7), the next higher floor or elevated ftoar (elevation b) of the building is _ ft,(m) _in,(cm) above the highest adjacent
grade, Complete items C3h and C3.i on front of form
E4, The top of the platform of machinery and/or equipment servicing the building is _ ft,(m) _'n,(cm) 0 above or 0 below (check one) the highest adjacent grade, (Use
natural grade, ij av~lable),
ES, For Zone AO only: If no flood depth number is available, is the lop of the bottom floor elevalecl in a::oordance with the community's floodplain management ordinance?
Dyes 0 No 0 Unknown, The local official must certify this information in Section G,
SECTION F. PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owners authonzed representative who competes Sections A, B, C (Items C3,h and C3i only), and E for Zone A (without a FEMA,ssued or community,
issued BFE) or Zone AO must sign here, The statements in Sections A, B, C, and E are correct to the best of my knowtedge,
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZiP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
o Check here if attachments
SECTION G. COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, S, C (or E), and G of this Elevation
Certificate, Compete the applicable item(s) and sign below,
G1, 0 The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information, (Indicate the source and date of the elevation data in the Comments area below,)
G2, 0 A community offidal completed Section E for a building located in Zone A (without a FEMA-Issued or community,issued BFE) or Zone AO,
G3 0 The fdlowing information (Items G4-Gg) is provided for community ftooJplain managemenf purposes,
G4, PERMIT NUMBER G5, DATE PERMIT ISSUED G6, DATE CERTIFICATE OF COMPLc<\NCEIOCCUPANCY ISSUED
G7, This permit has been issued for: 0 New Construction 0 Substantial Improvement
G8, Elevation of as-built lowest ftoor (including basement) of the building is:
G9, BFE or (in Zone AO) depth of ftooJing alth" building sije is
LOCAL OFFICIALS NC<\ME
COMMUNITY NAME
SIGNC<\ TURE
COMMENTS
ft,(m)
ft,(m)
Datum
Datum:
TITLE
TELEPHONE
DATE
o Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions