FEMA-EC950831 (3)The City With A Beautiful Future
BUILDING PERMIT APPLICATION
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2. f? int or Type in a Clear, Legible Manner AUG 0 95
Job Address: O o (r r-7 Date: F /
Lot: �3 3 Block: Subdivision: r� Phase or Section Number: 2
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Owner: G1 /7/0e -7e s' Address: %6610 / Phone #: 380-2-366 P>-/ 3 60
Contractor: ' " Address: Phone #: L `
Description of Work to be Done Cl"Work: ew ❑Addition ❑ Alteration ❑ Repair
1--111 ^ pa ❑Demolition
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of Building in Square Feet z-7
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First Floor Garage <7 U Value of Work
/f �% /� to be Performed � 20) 0011�)Second Floor (( l 0
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GRAY AREA FOR OFFICE USE ONLY
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FPMC - 1 (4/94) � �� _ �%
ELEVATION CERMay31,
TIFICATE Expire. -0°"
Expires May 31, 1993
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
BUILDDINGG WNER'S NAME / POLICY NUMBER
-- 1 45s-1
STREET ADDRESS (Includi Apt., Unit, Suite and/or dg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)�-
-�'—.Z
CITY STATE ZIP CODE
<: 772
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
(in AO Zones, use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 1-iit VD '29 F_I 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: _�1_;___ _�.i_1 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 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 19J 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 L__L-1�_� .LJ 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 I. i J . [ -I feet above n or
below [_ J (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_ I_ . 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? �_- [_I No [_i Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: ?NGVD '29 !!_-I 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 71, 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: es D-11No (See Instructions on Page 4)
!
5. The reference level elevation is based on: _ RMactual 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: _-1!i .%, 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: feet NGVD (or other FIRM datum -see Section B, Item 7).
2. Date of the start of construction or substantial improvement
F FMA rrer+r. F1 31, Mnv PO F{. Ccr- RFV'rt3 F- �inF cnn ('r)r�-TWIi i,
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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.
I certify that the information in Sections B and C on this certificate represents my best er ret the data available.
I understand that any false statement may be punishable by fine or imprisonment u
i� 8ection 1001.
CLICENSta��
ERTIF
TITI C - - -- _
EfjAW mROWELL
-- MPANY NAME q 46 8 ;4
ADDRESS cf�-
CITY
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/`�' �4 G alp+ STATE ZIP
SIGNATURE — — -- - �,�i�® _- __
Tx
DATE / PHONE
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Copies should be ma of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
ON WITH
SLAB ON PILES,
BASEMENT PIERS, OR COLUMNS
A v
A A y
CONES ZONES ZONES
ZONES ZONES
REMERFNCE REFERENCE.
LE VFL BASE IEVEL
REFERENCE
FLOOD
LEVEL
ELEVATION
-- t
RACE
FUK) ADJACENT REFEHF_NI;E
ELEVAIION REFERENCE ADJACFNT GRADE - LEVEL
BASE
ELEVATION
LEVE1. 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 ?
HR SURVEY PLAT HR
LOT 33R, BLOCK E, OF REPLA 34, BLOCK E, GIBBS STATION
PHASE TWO, AN ADDITION TO THE CITY OF COPPELL, DALLAS COUNTY, TEXAS.
LOT 32R
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F THIS PORTION OF THIS PROPERTY LIES
WITHIN THE 100 YEAR FLOODPLAIN
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MEAS. CH. 70.40'
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I hereby certify that on the—=day of /t16 • 1995 this survey was made on the ground ae per the field notes shown on this survey
and is true, correct, and accurate as to the dimensions of the subject property and size, location and type of buildings and improvements thereon,
if any. The survey shows all easements and visible easements of which I have knowledge or have been advised affecting the subject properly.
Then are no encroachments, conflicts, or probvsions visible on the ground other than those shown.
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Date AUGUST 31, 1995 JOBGF No.
19 LEGEND 0
1/2" Steel / Iron Rod Found O
f/2" Steel / Iron Rod Set
Property Line
Food Fence — . — . — . — —
Chain Link / wire Pence x—x—x—x—x
Overhead Electric E E— E —
Scale: I" = Z-,5-'
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HARRY
R 0 WELL
d Associates, INC.
Surveying k Engin
1301 Elm Street Ste. 20f
Carrollton, Texas 75006
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PLANS ARE REVIEWED FOR
APPROVAL, OF SINGLE
FAMILY Rs_ IDENCE 011: y.
OTHEP =- :PICTIONS OR
CALL -OUTS ON PLOT PLAN
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BEEN REVIEWER
ARE MI APPROVED.
ir.1W OF COPPELL
REVIEWE
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DATE
Ap(,r.r.;:; of the plans and specifications shall not
t;: + : , 'near! construction in direct cc','.
tl )m 'oppell Building Codes �3
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NORTH
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SITE PLAN
SC: 1"-20'-0"
LOT 33R BLOCK E
GIBBS STATION
PHASE TWO
COPPELL, TEXAS
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