FEMA-EC030331FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD tNSURANCE PROGRAM
Q,M,8, No, 3067-0077
Expires July 31,2002
ELEVATION CERTIFICATE
Imoortant: Read the instructions on Daaes 1 .7.
SECTION A. PROPERTY OWNER INFORMATION For Insurar<e Company Use:
BUILDING OWNER'S NAME Policy Number
BUILDING STREET ADDRESS (Induding Apt, Uno, Suite, andlor Bldg, No,) OR P,O, ROUTE AND BOX NO, Company NAIC Number
631 DEFOREST COURT ROAD
CITY STATE ZIP CODE
COPPELL TX 75019
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 9 OF DEFOREST COURT ADDITION
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENIAL
LATITUOE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type):_
If-##,#If' or ##,-l [8]NA01927 DNAD1983 o USGS Quad Map o Other:_
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81, NFIP COMMUNITY NAME & COMMUNITY NUM8ER
COPPELL480170
82, COUNTY NAME
DALlAS
83, STATE
lEXAS
84, MAP AND PANEL 85, SUFFIX 87, FIRM PANEL 89, BASE FLOOD ElEVATlON(S)
NUM8ER 86, FIRM INDEX DATE EFFECTIVffiEVISED DATE 88, FLOOD ZONE(S) (Zone AO, use depth offooding)
48113C0155 J Q8-23.()1 AE 452
B10, Indicate the source of the Base FkxxI Elevation (BFE) data or base flood depth entered in B9,
D FIS Profile IZI FIRM D Community Determined D Other (Describe):_
B11.lndicatethe elevation datum used for the BFE in B9: D NGVD 1929 IZI NAVD 1988 D Other (Describe): _
B12, Is the buikJing located in a Coastal Barrier Resources System (CBRS) area or Otherv.1se Protected Area (OPA)? D Yes D No Designation Date
SECTION C" BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1, Building elevations are based on: D Construction Drawings' IZI BuikJing Under Construction' D Fin.hed Construction
A new Elevation Certificate ",II be required when construction of the building. IXlI11plete,
C2, BuikJing Diagram Number 1 (Select the buikJing diagram rrost similar to the building for which this certificate. being IXlI11pleted - see pages 6 and 7, ~ no diagram
accurately represents the building, provkJe a sketch or photograph.)
C3, Elevations - Zones A 1-A30, M'., AH, A (with BFE), VE, V1-V30, V (with BFE), AA, AAlA, AAlAE, AAlA 1-A30, AAlAH, AAlAO
Complete Items C3,-a-i below according to the buikJing diagram specified in ~em C2, State the datum used, ~ the datum. 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 conl'efSion ca~ulation, Use the space pro~ded or the Comments area of
Section D or Section G, as appropriate, to document the datum conl'efSion,
Datum Conversion/Comments
Elevation reference marl< used _Does the elevation reference marl< used appear on the FIRM? D Yes IZI No ,
o a) Top of bottom floor (including basementorencklsure)
456.. ~
fl(m)
o b) Top of next higher floor _,_I,(m)
o c) Bottom of I""""t horizontal structural member ry zones on~) _' _fl(m)
o d) Attached garage (top of slab) _' _fl(m)
o e) Lowest elevation of machinery and/or equipment
servidng the building (Describe in a Comments area) _' _I,(m)
o D L""""t adjacent (finished) grade (LAG) _' _I,(m)
o g) H~hest adjacent (finished) grade (HAG) _' _I,(m)
o h) No, of pennanent openings (flood vents) within 1 I, above adjacent grade_
o i) Total area of all permanent openings (flood vents) in C3h_sq, in, (sq, cm)
SECTION D . SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a iand surveyor, engineer, or architect authorized by law to certify elevation information,
I certify that the information in Sections A, e, and C on this certificate represents my best eflorts 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.
CERTIFIER'S NAME HAARY ROWELL LICENSE NUMBER 4597
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TITLE SURVEYOR COMPANY NAME HARRY ROWELL COMPANY
ADDRESS
1301 ELM STREET STE201
SIGNATURE
CITY
CARROLL TON
DATE
03-3H)3
STATE
TX
TELEPHONE
972) 242-5679
ZIP CODE
75006
FEMA Form 81-31, JUL 00 SEE REVERSE SlOE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS