FEMA-EC940216TM ilding'"pectin sDi BUILDING PERMIT APPLICATION tf 0 4
Building Inspections Dirision
2 Print or Type in a Clear, Legible Manner
Job Address: I 52,` c, Date: 1
Lot: �( ,Block: ID Subdivision: � y� �- r � Phase or Section Number: I
Owner: n 1,, rn Address: sizo U3� r--a-tE-LjA,/ Phone #:1 j s-5 _ CI qD q
Contractor: µ� Address: DA `LA s 'Tk '15 Z 40 Phone /{: ��3 Vi
J
Description of Work to be Done Class of Work: ekNew []Addition ❑ Alteration [I Repair ❑Demolition
i �1Cs�r2amlL-y 1�e-SIDE7�-T%4qL- -:Ek
SIR • 1 12/92)
ELEVATION CERTIFICATE O.M.B. -0077
Expires mMay ay3i31,, 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 LOMR).
Instructions for completing this form can be found on the following pages.
BUILDING OWNER'S NAME
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I
POLICY NUMBER
STREET ADDRESS (Including Apt.. Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
Lot 26. Block D. Lakewood Estates
CITY STATE ZIP CODE
City of Coppell Texas 75019
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)
480170
0010
D
10/16/91
---
---
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): X NGVD '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: 449,0'' 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 _1— .
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 45.0 7 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 „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 feet above — or
below a (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 _ 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: X 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 77, 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 X No (See Instructions on Page 4)
5. The reference level elevation is based on: X 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: 449.3_ 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 1/10/94
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.
I certify that the information in Sections 8 and C on this certificate represents my best efforts 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 LICENSE NUMBER (or Affix Seal)
Dan B Ramsey R.P.L.S. No. 4172
TITLE COMPANY NAME
Surveying Manager Jones & Boyd, Inc.
ADDRESS CITY STATE ZIP
0 Dallas Parkway, Sui
SIGNATURE
allas
Z//
PHONE
exas 75248
Copies should be made of tjfs Certificate for: 1) community official, 2) insurance agenticompany, and 3) building owner.
ON Wmi ON PILES.
SLAB BASEMENT PIERS. OR COLUMNS
A V A A V
ZONES ZONESZONES ZONES ZONES
REFERENCE
_EVEI REFERENCE
REFERENCE ?ASE _EVEL
_EIEL BASE
ELEVATION
SASE
SASE ADJACENT REGEAENCE 'LOOC
`i DOC GRAOE _=VEL ELEVATION
ELEVATION gEFERENCE ADJACENT
_EYEL GRAOE
ADJACENT
At.._ .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 2
. . FOUNDATION FORM SURVEY
TO ALL PARTIES INTERESTED IN PREMISES SURVEYED:
This is to certify that I have, this date, made a careful and accurate on the ground survey of the property located
at L,��_t`Lo11�r �� 1?IlVe__- in the C_ fie_0y pRpeL L __________,Texas, described as follows:
BEING Lot efa-, Block LZ, of __________________________________,an addition to
the _.CL*_Qe_C—Ll_ Texas according to the /xa_ thereof recorded in y�/1![�Le Q�v14 Po��i7Q
of the /YR&_ Records of County, Texas.
This property does not lie within the boundaries of the 100—year flood plain according to the flood boundary and
floodway Map No.4�9170 OU/OD — effective _QC- Ger &' L291�� as shown,i /r/z" /eF
4..3005,5"00"
L= 26.98'
N
O
h
V
07
Z017 74' (0 1.&S
/\I'— �'/"
• Access ( Flood
Plain Esmt.
/ I Vol. 930/4, P9,G7o
oa
m
u2••rac •
�IV
moo, Cot 210, Block D O Lot Z7
,� I /52 Ho//y Wood Drive O
N
Top o f Form E/ety, = 450.74
5../I'
V I \
-30'x k01
1/i5;6; Msm
Vo 1. 93014, P9 6 70
i>+ ao I i .1�t IF r
+\ NO2 0/7 4(5
`I/2"rRF
i
/0' Ufi/ify FSmf. (/o 1. ?3014, Pg 107
5' TO, 6- Sm 110 /. 930/4, Py, &74
2S' aoi ldin
✓e/. 990/�,P�.G7
CERTIFICATION re. 450.76 T.C. 449.90
The plat hereon is a true, correct and accurate representation of
the property as determined by this survey, the lines and dimensions
of said pro ert beingas indicated b the plat; the size, location, Q u
type of buildings andimprovementsare shwn, improvements /7Z 7 400 DAI E
being within the boundaries of the property, set back from the°s-
propertylines the distances indicated, and there are no
encrochme r protrusions, except as noted.
47 ..'
I„'►
0•a •ea aauy.
�a co+•a
Dan B. Ramseyu; r'.3.
Registered Professional/d d Surveyor No. 4172 a••,•,a,,,,3 .,.•..., a•. o ••
6
N 4172
JONES do BOYD INC. `` `
' a w•sw e•a, el ro"do
1U1 Ina -M CONSULTING ENGINEERS
17300 Dallas Parkway, Suite 3010
Dallas, Texas 75248
FM 11 214-248-7676
/ Reuised Survey 2//4/94 06',E'
SCALE:DATE DRAWN PROJECT
1"=2a' ///4/94 6.41.Y. XA306 REVISIONS
SENT BY:Jones & Boya, -rc, "2- 5-55 2:48PM ;
Ufa
TF
sl 69.63'
SCALE: 1 20' /
47 1
(31.10)
St.IO ( — 30.0' B.L.. A. do F.P.E
(49..i0
2-0" ! 41JO G
J
ke 10 '4130m
�E� O
GS 49.50 ` ' m 1
al L32738
4 11" '
I
FF 50.00 I 1
1
m
1
2 01 411
49 30
\ .ae0 MAJO) 26.0' 91.
\ 49.0o
'00— V_E. 4d60.._. -II
--7—\--in7ITT --
�522555- 414 45u '16[3;ii Y
t
M
N
rc 5&W HOLLYWOOD DRIVE K 40
NOTE: Maximum Nevation drop away from foundation Is 0.8' for ♦';
sod remalninq slope If steeper than 31, , retain It steeper
than 2:1. Superintendent to ceases actual field conditions.
Drive Area: 936 Sq.Ft.
Walk Area: 931 Sq.Ft.
Lot Area: 111350 Sq.Ft.
F. F. M ,:,, r-" —71,p d
n
,k
Ma f p` 9 { _ q2/ q !
Trendmaker Homes
5720 LBJ Freeway. Suite B 10
Dallas. Texas 75240
we"rhaeuser (214) 458-9909
Type 'A' Drainage
date
11/30/93
rev
12/03/93
subdiv
LAKEWOOD ESTATES
lot blk
26 p
address
LOT 24
8'-1"
440
Fence Lonoth: 70'
ALL
NotEO, rQl x
ARE 4EN
I HOLLYWOOD DRIVE
7COPI
plan
ELL, TX 32738 LEFT