FEMA-EC950425The City With A Beautiful Future
BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Job Address:
-72--+ CASTL*---
Date: , / // - f5 --
Lot:
Block: Subdivision:57i fir-
Phase or Section Number:
Owner: -�
Address:r �P _ 1
Sa><'
Phone #: 3q 3 -
Contractor:
Address:
Phone #:
Description
rk*o-b ne Class of Work:New ❑Addition ❑ Alteration El Repair
[]Demolition
I PP D fav 5t DYJ 6�, ;Va- 01J0 A-r1O.c)
Fc� np4vj
Area of Building in Square Feet
First Floor
t
Second Floor
Garage
Other
10110 Ce) VV,
This permit becomes null and void if work or construction authorized is not commenced
within 180 days, or construction on work is suspended or abandoned for a period of 180 days
at any time after work is commenced.
I hereby certify that I have read and examine on and know the same to be true
and correct. All provisions of law d ordinanc governing this type of work will be
complied with whether specified rein or not. granting of a permit does not presume to
give authority to violate or e pro ' ons of any other federal, state or local law
regulating construdioty�or ce nstmctioa
Signaoebf Contractgf/or Auth Agent
Electrical Contractor Plumbing Contractor
FPMC - 1 (4/94)
Print Name
Mechanical Contractor
Value of Work
to be Performed
GRAY AREA FOR OFFICE USE ONLY
f\l.v UI -�Nl.R Int 1.\V, IL'A�1J `I-10-: i) 11 :VUAll
lL11I EC1H AT&T GIS:# 2
HOLD HARMLESS AGREEMENT
WHEREAS, THE OWNER OF LOT --7 -. BLACK G , OF THE
sr sof �+ - ^"mo - SUBDIVISION, -724 e,4:5*A- G -
(ADDRESS), COPPELL, TEXAS (THE OWNER) UNDERSTAND AND
ACKNOWLEDGE THAT THE DRIVEWAY WHICH IS LOCATED ON THEIR PROPERTY
ENCROACHES ONTO THE CITY OF COPPELL'S DRAINAGE EASEMENT;
AND
WHEREAS, THE OWNERS UNDERSTAND AND ACKNOWLEDGE THAT IN CASE
REPAIRS OR IMPROVEMENTS ARE REQUIRED TO BE MADE TO THE CITY OF
COPFELL'S DRAINAGE EASEMENT WHICH WOULD REQUIRE REMOVAL OF THE
DRIVEWAY TO EFFECT SUCH IMPROVEMENTS; AND
WHEREAS, THE OWNERS RECOGNIZE AND ACKNOWLEDGE THAT SUCH
DRIVEWAY WAS INSTALLED DESPITE KNOWLEDGE OF THE CITY'S DRAINAGE
EASEMENT;
OWNERS HEREBY AGREE TO REMOVE SUCH DRIVEWAY AT THEIR OWN COST
AND UPON REQUEST BY THE CITY OF COPPELL, AND IF OWNERS FAIL TO
REMOVE THE DRIVEWAY UPON REQUEST BY THE CITY, THEN CITY WILL REMOVE
SUCH DRIVEWAY AND OWNERS HEREBY INDEMNIFY AND HOLD THE CITY
HARMLESS FROM ALL CLAIMS OF DAMAGE TO THE DRIVEWAY WHICH ARISE FROM
THE CITY`S REMOVAL OF SUCH DRIVEWAY WHILE REPAIRING, INSPECTING,
IMPROVING OR IN ANY WAY SEEKING ACCESS TO THE DRAYNAGE EASEMENT.
ADDITIONALLY,
OWNERS AGREE TO REIMBURSE THE CITY FOR REASONABLE COSTS INCURRED IN
REMOVING THE DRIVEWAY.
DATEI
TOTAL P.02
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SURVEY PLAT JIMMY W. POGUE; INC.
This is to certify
that I have, this date, made a careful and accurate survey on the ground ofl property located a I t
. 'CRE. Coj22ET.L,
ATZE 'CREM DRTME- in the city of, -------
Lot
7 TN , Block No. C City Block No
LO No.
of THE XS—TI- PF 9MARIDGA MANOR, an addition to th,e
City a CPP' LL LiALLAS COUINTY r Texas, according to the 1KAP thereof
recordod In Voltum '94250 page 4 _6, --MP— Records DALLAS i County. Texas,
NOTE: I DID NOT MARCH THE COUNTY RECORDS TO DETERMINE EAS61ENTS OR
RECORD TITLE. ALio INTMESTED PARTIES SHOULD EMPLOY A TITLE AND ABSTRACT
COMPANY TO bETER.MiNE EASEMENTS AND STATE OF TITLE AND OWNE49HIP TO THIS
PROPERTY.
COON AREA
N 00*23' 45" E (REFERE
0 0 BEARING FROM PLAT)
7
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0 0 1 3 0 fo.Go 10.0
. 70 1 111 11 1111111
6
C A
P-11...TLEI CREEK DRIVE
The plot WON Is a "Is for"I &wuifi* by on the ground survey, tbA Ham
ma dimmisifts of said prowty"I a int by 66 Vint; 66 An, lmdoo ad type of buildigs and
t mprovemma we is Wiowd, id I 1m*vgI befPS within the bounI of the property. setback ftm i IMM
propeny Um the d1aftwe bdosI ad that tho distsocet fivA Ms wrest intersecting stmt. or road.
is is *Wn on &W pw. ft. omm *M010"Is as so $how%, it
Tit I AM NO INCROAC30MTS 01 P10MUSIONS. Is
1"-20' This survey 461 pakerssid in tenraction with dw km"I I
Scale &scjjbwj&cr,jqo._ FOR: I
or BRIENTWOOD BUILD S
Dsw Me company, Use Or dirt samey f0f any other ptur" or any
JOB Na 60298 *www by JbMV W. Pop% Ine. sod A other r uam "d&n,
*jftU? PW Wfisea 00010t ofAMMY W. POM bt.
JI
1A.
C W. I(( Er PRESIDi*'
r W. POG E, INC.
P
MM W. VOGUE, INC.
3510 MAR VIN r-. LOVE FREEWAY
DALLAS,TEXAS 75224
PHO1M (214) 371-0666
�7W-24-1995 12:27 -IRM 31".1MY Id. POGUE. ft -41-. F.0 '
INK
. No 306 7-0077
ELEVATION CERTIFICATE Expires May
Expires May 3 J, J 993
FEDERAL EMERGENCY MANAGEMENT AGENCY
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 LOMB).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
POLICY NUMBER
BUILDING OWNER'S NAME
STREET ADD ESS (I luding Apt., Unit, Suite a /or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
14�T L ��
O HER DESCRIPTION (Lo nd Block Numbers, etc.) �f
/ STATE ZIP CODE
CITY A)& 77—/
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFO MATION
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. (in AOASE Zones,
use
ELEVATION
d
{
Y2 0
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): WGVD '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 —❑_11.L_l 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 __ .,,CCU' '���tt,..t� ee,,
2(a). FIRM Zoe//sII Al 30, AE, AH, and A (with BFE). The top of the nsfadu�eeJlsor from the selected diagram is at an elevation
of ❑._ feet NGVD (or other FIRM datum -see Section B, Item 7).
(b). FIRM Zones V1 430, 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 LL❑_L_i._J 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 LSI .❑ 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 ❑ .❑ 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: ,-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 k No (See Instructions on Page 4)
5. The reference level elevation is based on: 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: 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: � ._L_L❑ .I—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 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.
t�
I certify that the information in Sections B and C on this certificate represents my best efforts to interpi4_,V a data available:
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,ueetion LOOi.
FIER'S NAME LICENSE NUMBER (or Affix Seal) tyv ,,',e��a 6 :�rF
COMPA NAME
7/s AT� L / l� L.� (/ ' CITY
Donis should "de of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
t.
ON WITH ON PILES,
BASEMENT PIERS, OR COLUMNS
SLAB
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
LEVEL
REFERENCE
REFERENCE BASE
LEVEL
LEVEL FLOOD
ELEVATION
BASE
EFERENCEAAENT
FLOOD
BASE
FLOOD GRADE LEVEL
ELEVATION
ELEVATION REFERENCE ADJACENT
LEVEL 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.
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