FEMA-EC040825NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
O.M B No 3067-0077
Expires December 31, 2005
SECTION A - PROPERTY OWNER INFORMATION For Insuran~ Company Use:
BUILDING OWNER'S NAME Policy Number
BUILDING STREET ADDRESS (Including Apt Unit, Suite, and/or Bldg No) OR PO ROUTE AND BOX NO.
23 DEFOREST COURT ROAD
Company NAIC Number
CITY STATE ZIP CODE
COPPELL TX 75019
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parce~ Number, Legal Description, etc)
LOT 7 BLOCK A DEFOREST COURT
BUILDING USE (eg. Residential, Non-residential Addition, Accessory, etc Use a Comments area, if necessary)
RESIDENTIAL
LATITUD~/'LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: [] GPS (Type):
dC#C"or ##//I/l/I/fl°) []NAD1927 []NAD1983 []] USGS Quad Map I3~ Other: FIRM
SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1 NFIR COMMUNITY NAME & COMMUNITY NUMBER B2 COUN'D/ NAME
COPPELL 480170 DALLAS ! TEXAS
B4 MAp AND PANEL ! B7 FIRM PANEL
NUMBER B5 SUFFIX B6 FIRM INDEX DATE ! EFFECTIVE/REVISED DATE B8 FLOOD ZONE(S)
4811300155 J AUG 42004 I OCT 1 2003 X
BIOi bdicateihe source of the Base Flood Eievat'on (BFE) data or bose flood depth entered in B9
FIS R/pile [] FIRM [] Community Dete~ined [] Other (Describe):
Bll, Indicate the elevaflon datum used for the BFE in B9: r~7] NGVD 1929 El NArD 1988 []Other(Describe):
B12~sthebui~din9~ca~edlnaC~asta~BarderRes~urcesSystem(CBRS~area~r~therwisePr~tectedArea(~PA)? []Yes []No BesignationDate
SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
B9 BASE FLOOD ELEVATION(E)
Zone AP use dep~ of flooding)
4525
C1 Building elevations are based on: [] Construction Drawings* [] Building Under Construdion* [] Finished Construdion
A new Elevation Cedificae will be required when construction of the building is complete
C2 Building Diagram Nurnee~ 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 (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, AR/AE, AR/Al-A30, AR/AH, AR/AP
Complete Items C3-a i below according to the building diagram specified in item C2. State the datum used If the datum is different from the datum 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 D or Section G, as appropnate, to document the datum consers~on.
Datum NGVD1929 Conversion/Comments BM PROVIDED BY RECORD PLAT HALF AND ASSOC
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? [] Yes [] No
a) Top of bottom floor iincludiog basement or enclosure) 455 75 fl.(m)
b) Top of next higher floor NA _fi(m)
c) Hoflom of lowest horizontal structural member (V zones coly) NA fi(m)
d) Attached garage (top of slab) NA _fi(m)
e) Lowest elevation of machinery and/or equipment
seP,,icing the building (Describe in a Comments area) NA fi(m)
Lowest adiacent (finished) grade (LAG) 454 67 fi(m)
g) Highest adjacent (finished) grade (HAG) 454 93 fi(m)
o h) No of permanent openings (flood vents) within 1 ft above adjacent grade N~A
o i) Total area of all permanent openings (flood vents)in C3h N~A sq. in (sq, cra)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certflication is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information
I certify that the mformahon m Sections A B and C on this cedlf~cate represents my best effods to mterpret the rtata available.
understand that any false statement may be p n shabe by fine or imprisonment under 18 U.S Code, Section '1001
CERTIFIER S NAME BARRY RHODES LICENSE NUMBER 3691
TITLE OWNER COMPANY NAME HARRY RHODES
ADDRESS CITY STATE ZIP CODE
7509 PENNRIDGE CIRC~-E ,/~ ROWLETT TX 75088
SIGNATURE ~ --~------& , - DATE- TELEPHONE ---
08-25-2004 972475-8940 ....
FEMA Form 81,~nuary 2005 ~ See reverse side for continuation Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A,
BUILDING STREET ADDRESS (tnduding Apt, Unit Suite. and/or BbS. No ) OR P 0 ROUTE AND BOX NO
23 DEFOREST COURT ROAD IFor
Insurance Company Use:
Policy Number
Company NAIC Number
CITY STATE ZIP CODE
COPPELL TX 75019
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Cedificate for (1) community offcial, (2)insurance agent/company, and (3~ building owner
COMMENTS
Check here if attachments
SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AC and Zone A (without BFE), complete Items E! through E4 !f the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR F
Section C must be completed
El. Building Diagram Number_(Select the building diagram most similar to the building for which this cediflcate is being completed- see pages 6 and 7 Il no diagram accurately
represents the building, provide a sketch or photograph )
2Thetupofth~bo,,[u,/,fl~,ii;~...j,i,auasun~l~i.~lcncl~u~e),cfthebuJldi;~9i~ fi(m) ia(cm)Daboveo~ I~] below (check one) the highesl adjecent grade (Use
natural grade, if available)
E3 For Building Diagrams 6a with openings (see page 7), the ne×t higher fluor or elevated floor (elevation b) of the buildiog is _ ~l(m) __in (ce/) above the MghesI adjacont
grade Complete items C3 h and C3 i on front of form
E4 The top of the platform of machinery and/or equipment servicing the building is _ ft.(m)_in (cra) [] above or [] below (check one) the highest adiacent grade (Use
natural grade, if available)
E5 For Zone AC only: If noflood depth number is available, is thetop ofthe bottom floor elevated in accordance with the community's floodplain management ordinance?
Yes E~No [_-~]Unknown ThelocalofficialmustcertifythisinformaticeinSectionG
SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
issued BFE) or Zone AO must sign here The statements in Sections A, B C and E are correct to the best of my know/edge
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
Check here if attachments
SECTION G- COMMUNITY INFORMATION (OPTIONAL)
The local offcial who is authonzed by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation
Certificate Complete the applicable item(s) and sign below
G1 [] The information in Sectico C was taken from olher documentation that has been signed and embossed by a licensed sun~eyor, engineer, or archited 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 [] A community official completed Section E for a building located i~ Zone A (without a FEMA-issued or community-issued BFE) or Zone AC
G3 F~ The followinq information fltems G4-G9/is provided for communily floodplain managemef~t purposes
G4 PERMIT NUMBER G5 DATE PERMIT ISSUED G6 DATE CERTIFICATE OF COMPLIANCE/OCCdPANCY ISSUED
I
G7 This permit has been issued for: [~] New Construction E~] Su bstanflal Improvement
G8 Elevation ol as-built lowest floor (including basement) of the building is:
G9 BFE or (in Zone AC) depth of flooding at the building site is:
fi(m) Datum:
fi(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNAq UR~ DATE
COMMENTS
Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions