FEMA-EC050805FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
O.M.B. No. 3067-0077
Expires December 31,2005
ImDOrtant Read the instructions on PlI!Ies 1 .7,
SECTION A. PROPERTY OWNER INFORMATION For IllSUIance Con1>any Use:
BUILDING OWNER'S NAME Policy Number
BUILDING STREET ADDRESS (Indudlng Apt., Un., Suite, and/or Bklg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
604 INGLENOOK COURT
CITY STATE
COPPELL TX
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 1 BLOCK A ST ANDREWS ESTATES
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENTIAL
LATITUDElLONGITUDE (OPTIONAL)
or ##._~
ZIP CODE
75019
HORIZONTAL DATUM:
I:8l NAD 1927 0 NAD 1983
SOURCE: 0 GPS (Type):_
o USGS Quad Map I:8l Other: FIRM
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME & COMMUNITY NUrJBER
COPPELL 480170
82. COUNTY NAM'
DALlAS
83. STATE
TEXAS
84. M\P AND PANEL 87. FIRM PANEL 89. BASE FLOOD ELEVATION(S)
NUMBER 85. SUFFIX 86. FIRM INDEX DATE EFFECTIV5REVlSED DATE 88. FLOOD ZONE(S) (ZoneAO, use cIep1tIoflllodilJ)
48113C0155 J 08<J4-2004 11){)1-2004 ~ NA
B10.lndicatethe source of the Base Flood Elevaion (BFE) data or base flood depth entered in B9.
o FIS Profile [gJ FIRM 0 Community Oetennined 0 Other (Describe):_
B11.lndicatetheelevation datum used for the BFE in 89: [gJ NGVD 1929 0 NAVD 1988 0 Other (Oescribe): -
B12. Is the builrnnglocated in a Coastal Barrier Resources System (CBRS) area or Othoovise Protected Area (OPA)? 0 Yes [gJ No DesignatkJn Date
SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building eevalions are based on: 0 Construction Dra.vings' [gJ Building Under Construction' 0 Finished Construction
A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1 (Seect the buikling diagram most similar to the building for v.f1ich this cerllicate is being competed - see pages 6 and 7. If no diagram
accurately reprESents the building, provide a sketch or photC(Jraph.)
C3. Elevations - Zones A1-A30, AE, AH, A (,.;th BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH, ARlAO
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 10 that used for the BFE. Show fied measurements and datum conversion calculation Use the space provided or the Commenls area of
Section D or Section G, as appropriate, to document the datum conversion.
Datum NGVD1929 ConversionlComments BM PROViDED ON RECORD PLAT DEFOREST COURT BY HALF AND ASSOC.
Elevation reference marl< used _Does the e1evaion reference mark used appear on the FIRM? 0 Yes [gJ No
o a) Top of bottom floor (induding basement or endosure) 467. 87 ft.(m)
o b) Top of next higher floor 463.B8ft.(m)
c) Bottom of lowest horizcnt~ structur~ member (V zones only) NA . _ft.(m)
o d) Attoched garage (top of slab) 463. 88 ft.(m)
o e) Lowest elevation of machinery and/or equipment
servicing the building (Describe in a Comments area) NA . _ft.(m)
o n Lowest adjacent (finished) gra;Je (LAG) 462 . 59 ft.(m)
o g) Highest adjacent (finished) grade (HAG) 467. 1!!.ft.(m)
o hi No. of permanent openings (flood vents) ,.;thin 1 ft. above adjacent grade NA
o i) Total area of all permanent openings (fiood venls) in C3.h ~sq. in. (sq. em)
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 ,Ievation information.
I certify that the information In Sections A. B, and C on this certificate represents my best efforts to interpret the data available
I understand Ihat any false slatement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME BARRY RHODES liCENSE NUMBER 3691
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TITLE OWNER COMPANY NAME BARRY RHODES
ADDRESS
7509 RIDGE CIRCLE
SIG
CITY
ROWLETT
DATE
1J8..05-2005
STATE
TX
TELEPHONE
972-47~940
ZIP CODE
75088
See reverse side for continuation.Replaces all previous editions
IMPORT ANT: In these spaces, copy the corresponding information from Section A. For Insuranre Company Use:
BUILDING STREET ADDRESS (Indudi,," Apt, Un~ Suie, andlorBkIg. No.) DR P.D ROlffE AND BOX NO. Pdicy Number
604 INGLENOOK COURT
my STATE ZIP CeDE Company NAIC Number
COPPELL TX 75019
SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVcompany, and (3) buiiding owner.
COMMENTS
D Check here if attachments
SECTION E. BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (v.ithout BFE), complete Items E1through E4. ~ the Elevation Cel1ificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C musf be completed.
E1. Buiiding Diagram Number _(Select the building diagram most similar fa the building for whk:h this cel1ificate is being completed - see pages 6 and 7. If no diagram aa::urately
represents the building, provide a sketch or photCXJraph.)
E2. The top of Ihe bottom fioor (induding basement or endosure) of the building is _ ft.(m) _in.(em) 0 above or 0 beiow (check one) the highest adja:ent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6-8 wilh openings (see page 7), the next higher floor or ,;evated floor (elevation b) ofthe building is _ ft.(m) _in.(em) above the highest adjacent
grade. Complete i1ems C3.h and C3.i on front of form
E4. The top of the platform of machinery and/or equipment servidng the building is _ ft.(m) _in.(em) 0 above or 0 below (check one) the highest adiacent grade. (Use
naturai grade, IT av<ila~e).
E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordalce with the community's floodplain management ordinance?
o Yes 0 No 0 Unknown. The local official must certify this information in Section G.
SECTION F . PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The properly owner or owners authorized representative who completes Sections A, B, C (Items C3.h ood C3.i only), ood E for Zone A (v.ithout a FEMA~ssued or community-
issued BFE) or Zone AO must sign here. The statements in Sections A. 8, C, acd E ate conBCt to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
SIGNATURE
CITY
DATE
STATE
TELEPHONE
ZIP CODEADDRESS
COMMENTS
o Check here if attachments
SECTION G. COMMUNITY INFORMATION (OPTIONAL)
The local offidal who ~ authOlized by law or ordinance to administer the community's floodplain malagement ordinance can complete Sections A. B, C (or E), and G of this Elevation
Cartmcate. Complete the applicable item(s) ",d sign below.
G1. 0 The infonnation in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify EJevation information. (Indicate the source and date of the elevation data in the Comments area beiow.)
G2. 0 A community off.;a! completed Section E for a building located in Zone A (without a FEMA~ssued or community-issued BFE) or Zone AO.
G3. 0 The following information (Items G4-G9) is provided for community floodpl<in management purposes.
G4. PERMIT NUMBER G5. DATE PERMrT ISSUED GG. DATE CERTIFICATE OF COM'UANCEIOCCUPANCY ISSUED
G7. This pem1it has been issued for: 0 New Coostrudion 0 Substantial Improvement
G8. Elevation of as-buiH lowest floor (induding basement) of the buikjing is:
G9. BFE or (in Zone AO) depth of flooding at the building sile is:
LOCAL OFFICIA~S NAME
ft.(m)
ft.(m)
Datum:
Datum:
TITLE
COMMUNITY NAME
SIGNATURE
COMMENTS
TELEPHONE
DATE
o Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previOUS editions