FEMA-EC931029Elec&ical Contractoi
BIR - 1 (2/92)
ELEVATION CERTIFICATE O.M.B. No 3067-0077
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires May 31, 1993
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
provide 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).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME
WESTCHESTER HOMS POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
916 BRENTWOOD DRIVE COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
Lot 37, Block A, VILLAGES OF COPPELL PHASE III B
CITY
COPPELL STATE ZIP CODE
TEXAS
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION
480170 0010 (In AO Zones, use depth)
D Oct. 16, 1991 AE 450.50
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): IVNGVD'29 ❑Other (describe on back)
8. 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: I I I I I , ❑ 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 1
2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of 1 1 1415 6I -"feet 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 I I I I 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 ❑J.0 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 ❑J . L.) 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: 0 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 7], then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: ❑ Yes 1XI No (See Instructions on Page 4)
5. The reference level elevation is based on: R actual construction ❑ 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.)
6. The elevation of the lowest grade immediately adjacent to the building is: I I I�� • g� feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
is 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: 1 1 I 1 1 I . ❑ 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, MAY 90 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 13FE),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.
/ certify that the information in Sections B 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 U.S. Code, Section 1001.
ROLAND RODRIGUEZ R.P.L.S. 4987
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal)
MANAGER JAMES H. DOWDY & ASSOCIATES
TITLE COMPANY NAME
155 NORWOOD D".410 HURST - TEXAS 76054
ADDRES CITY STATE ZIP
817-589-7107
SIG URE DATE PHONE
Copies should be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner.
COMMENTS: Elevation used— Top operating nut of fire hydrant 1001 North of
Chalfont Place. Elevation 456.93 ft. as shown on subdivision Plat recorded
in Volume 92218, Page 3565 DRDCT.
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE BASE LEVEL
REFERENCE
LEVEL FLOOD
LEVEL
ELEVATION
BASE ADJACENT::: REFERENCE
FLOOD
BASE
FLOOD
GRADE "' �+ • LEVEL
ELEVATION REFERENCE ADJACENT
ELEVATION
LEVEL GRADE
.y 1.
•�.•:. •. ...,.:>:.:::.¢,:.
..�%!ADJACENT;
'•'o'r.::• �•:....•r:`•;;}�.;:;::•n; A
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
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REFERENCE N0: 39422
Lot 37, Block A, VILLAGES OF COPPELL PHASE III B, an Addition to the City of
Coppell, Dallas County, Texas.
"FORM SURVEY"
DEFORSET DRIVE
S.89°44'05" E. 50.0'
I F 15' ALLEY
1/2" I.R. FND._
AT 110.0' _
1/2" I.R. FND.
W ' AT 110.0'
LOT 37 I
0.13 ACRES
O
38 ,ri 3,1-
36
o
w o
U0
FORMS —
i�
0
20' BUILDING Z ( uT
LINEo
—7.1'
N
— — — 15' UTIL ESM'T. — —
_7L.89*44'05"W.. 50.0'
1/2" I.R. FND.
1/2" I.R. FND.
916 BRENTWOOD DRIVE
NORTH
SCALE: 1 =30'
/.FrFNn
rENCE OVERHEAD ELEC.
) E
TELEPHONE
T
CONCRETE,
BRI K WOOD STONE
DEL�K DECK DECK
R.R. TIE RETAINING WALL
BRICK WALL
*_ (CONTROL MONUMENT)
SURVEYORS CERTIFICATION OF
The undersigned Registered Public surveyor .certifies to purchaser, Lender and Title Company as named above, �''< <'�' ,i"4�• + �\
and their Underwriters that (A) this plat of survey and the property description set forth heron are a true
and correct representation of facts found at the time of an actual on—the—ground survey; (B) such survey was
conducted by the surveyor, or under his supervision; (C) ail monuments shown hereon exist and the location,
size, and type of material are correctly shown; (D) except as shown, there are no visible encroachments orjD r i r R!G,iUl_Z
right—of—ways onto the property there are no visible discrepancies, conflicts, shortages in area of boundary ` �}
line, except as shown; (E) the size location, and type of improvements are as shown hereon.
1 r4
4 �W + 40
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ce®
3 Q I..-
JAMES H. DOWDY &
JAMES H. DOWDY, R.P.L.S. No. 2970
ASSOCIATES, INC.
1550 NORWOOD, SUITE 410 10-29-93 ROLAND RODRIGUEZ, R.P.L.S. No. 4987
HURST, TEXAS 76054
THIS SURVEY NOT VALID WITHOUT Ek! OSSED SEAL & ORIGINAL SIGNATURE