FEMA-EC940316r+� ass. s.rr rrrs-J%s �
C
BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Job Address: SAP 4*qe Date: )CW6 . !,5 !99 i
0
Lot: Block: /4 SUMV111ion: -4eKAIZZY XSTA ZLS Phew or Section Number:
owns . Address: Phone #:
Contractor: 444ft es 94 it ' It 'e- Address: lyp4 Ae4tSAW Phone #: OXy,Z 17 ? O
Description of Work to be Done Class of Work: ❑ New �❑AAddJition ❑ Alteration ❑ Repair ❑Demolition
of Builth in Square Feet
First Floor
Second Floor
Garage
Other
NOTICE
This permit become null and void if work or duction authorized n not commenced
within 180 days, or construction on work is suspended oe abandoned for a period of 180
days at any time ager work is commenced.
I hereby certify that I have read and examined this application and know the same to be true
and correct. All provisions of laws and ordinances governing this type of work will be
complied with whether specified herein or not. The granting of a permit don not prnume to
give authority to violate or cancel the pro of any other federal, state or local law
regulating tion or perfomamce tion.
t
34manare of or Ariapeftent Print Name
Electrical ca ractor Plwnbing Contractor Mechanical Contractor
RR - t 121921
Value of Work
to be Performed
-10'
th
31
LOT 11 @L K- A
t
�FGodo W.4Y
1r/:•/As !
0
1 ii¢F1/2 "ieF
DZICY E 53.20 R:5500' L: 4g,?g
18 COUNTRY LANE
PROPERTY DESCRIPTION
Lot 11 in Block A of Country Estates, an Addition to the City of
Coppell, Dallas County, Texas.
518 Country Lane
-Ame1iuut.Cwv".M*1M C.%Mpa"t,
7,-V- . or as' Inc.
57" LS J. ftwoul.'IMIF& 210
DaWbMsMN
(214)239-4369
DATE 3-/h'94
SCALE /~ 30B
DRAWN BY ks
rJ
a boo Property is located in Zone
according to the Federal
Insurance Administration national flood
Insurance program Flood Insurance Rate
Map. Community - Par Number.
4601-70—o6i0 0
Effective 10-140-91
G.F. NO.
.I.o.NO. 3-P72-94
BUYER
The undersigned does hereby certify that the foregoing plat correctly represents an accurate survey made on the ground and there
are no vl4ble conflcts, encroachments, overlapping of Improvements or easements except as shown; this plat correctly represents
the boundaries as found or located on the pound with resipect to the recorded refirencm gown and the area, If shown, cortectty
represents the area enclosed by sold boundaries. This property has access to and *om a dedicated roodway.
DATE'
N
a
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> 0'
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� TOP Or AOR
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2'R 9
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11.9
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1 ii¢F1/2 "ieF
DZICY E 53.20 R:5500' L: 4g,?g
18 COUNTRY LANE
PROPERTY DESCRIPTION
Lot 11 in Block A of Country Estates, an Addition to the City of
Coppell, Dallas County, Texas.
518 Country Lane
-Ame1iuut.Cwv".M*1M C.%Mpa"t,
7,-V- . or as' Inc.
57" LS J. ftwoul.'IMIF& 210
DaWbMsMN
(214)239-4369
DATE 3-/h'94
SCALE /~ 30B
DRAWN BY ks
rJ
a boo Property is located in Zone
according to the Federal
Insurance Administration national flood
Insurance program Flood Insurance Rate
Map. Community - Par Number.
4601-70—o6i0 0
Effective 10-140-91
G.F. NO.
.I.o.NO. 3-P72-94
BUYER
The undersigned does hereby certify that the foregoing plat correctly represents an accurate survey made on the ground and there
are no vl4ble conflcts, encroachments, overlapping of Improvements or easements except as shown; this plat correctly represents
the boundaries as found or located on the pound with resipect to the recorded refirencm gown and the area, If shown, cortectty
represents the area enclosed by sold boundaries. This property has access to and *om a dedicated roodway.
DATE'
• • M
95315 T-1
--
518 COUNTRY LANE
( ) S71u= Cil'
NATIONAL FLOOD I
ATTENTION: Use of this certificate does not provide a waiver of the
provide elevation information necessary to ensure compliance with.
determine the proper insurance premium rate, and/or to support a r
Instructions for completing this form
�+
^ O.M.B. NO. 3067, -0077
CERTIFICATE Expires May 31,19'116
MAKAGEMOff AGENCY
NS"ANCE PROGRAM
flood insurance purchase requirement. This form is used only to
p bable community floodplain management ordinances, to
equett for a Letter of Map Amendment or Revision (LOMA. or LOMR).
can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDING,OWNER'S NAME POLICY NUMBER
STREET ADDRESS (Including ApL, Un.k;vui4arid1or9 Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIL NUMBER I
OTHER DESCRIPTION (Lot arid b16& Numbeak etc.)
Le? 11 13 LmcJZ . A— Qt Gs Tis rens
CITY STATE ZIP CODE
coAPa6! T
SECTION S FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the folWsftftrrthe proper FIRM (See Instructions):.`^
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5: FIRM ZONE
8, BAS�i FLOOZo, D E1,3cvATION' -
Ao nes
(in uss,40)
r441-
7. Indicate the elevation datum system used on the FIRM for .Base Flood Elevations (BFE): *GVD '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 I , H feet NGVD (or other FIRM datum—see Section B, Item 7),
SECTION C BUILDINQ_ELEWATION INFORMATION
1. Using the Elevation Certificate Instructions, indicate the diigram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level
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 I I ISID 10 . Z feet. NGVD (or other FIRM datum—see Section 8, Item 7).
(b). FIRM Zones VI -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 .0 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 W . U 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 soloed diagram is W .0 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 r_1 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 . II measuring the elevations is different than that used on
the FIRM (see Sedfon 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 abe not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the courselof 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 III I , U .feet NGVD (or other FIRM datum -see
Section B, nem 7).
SECTION D COMMUNI
1. If the community official responsible for verifying bulkiing 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: U 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 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
(A
This certification is to be signed by a land surveyor, engineer, or arqhited who is authorized by state or local law to certify e19MIon
information when the elevation information for Zones Al -A30, AE, H, 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 AID 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 operiings, or unfinished area Feat (s), then list the Feat: re(q) not
included in the certification under Comments below. The diagram dumber, Section C, Item entered.
I certify that the information in Sections B and C on this certificate represents my best pvailab/e. , -
1 understand that any false statement may be punishable by fine or imprisonment u 1001.
CERTIFIER' LICENSE NU !�
TITLE� COMPANY -NAM
Z//*A,,o%' J:;;A4*,,di4 /�%iA►�i►is�
ADDRESS CITY STATE ZIP
S'7L! L tet, T. Ale t /v TJs 02'.4'j- 7" oro
SIGNATURE ',DATE -PHONE
Copies shouldfM mads of this Certificate for: 1) community official, 2) Insurance agwWcompany, and 3) buttding owner.
"I~S•
�n 17
A
ZONES
ON
SLM \�N
V
ZONES
Ohl
ON PILES,
PKIW GR
A V
The diagrams above illustrate the points at which the elev cis should be measured in A Zones and. V Zones.
Efevations for all A Zones should be measured at the top of reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
Page 2