FEMA-EC110324US DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No 1660 0008
Federal Emergency Management Agency Expires March 31 2012
National Flood Insurance Program Important Read the instructions on pages 1 9
SECTION A PROPERTY INFORMATION
Al Building Owners Name HOLMES BUILDERS r 7
A2 Building Street Address including Apt Unit Suite and or Bldg No or PO Route and Box No o r
608 INGLENOOK COURT
City COPPELL State TX ZIP Code 75019
A3 Property Description Lot and Block Numbers Tax Parcel Number Legal Description etc
Lot 2 Block 1 of ST ANDREWS ESTATES COPPELL DALLAS COUNTY TEXAS
A4 Building Use eg Residential Non Residential Addition Accessory etc RESIDENTIAL
A5 Latitude Longitude Lat Long Horizontal Datum NAD 1927 NAD 1983
A6 Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance
A7 Building Diagram Number NA
A8 For a building with a crawlspace or enclosures A9 For a building with an attached garageaSquarefootageofcrawlspaceorenclosuresNAsqftaSquarefootageofattachedgarage NA sq ftbNoofpermanentfloodopeningsinthecrawlspaceorbNoofpermanentfloodopeningsintheattached garageenclosureswithin10footaboveadjacentgradeNAwithin10footaboveadjacentgradeNA
c Total net area of flood openings in A8b NA sq in c Total net area of flood openings in A9b NA sq indEngineeredfloodopeningsYesNodEngineeredfloodopeningsYesNo
SECTION B FLOOD INSURANCE RATE MAP FIRM INFORMATION
B1 NFIP Community Name Community Number B2 County Name B3 StateDALLASCOUNTYINCORPORATEDAREAS48113CDALLASTEXAS
B4 Map Panel Number B5 Suffix B6 FIRM Index B7 FIRM Panel B8 Flood B9 Base Flood Elevations Zone48113C0155JDateEffectiveRevisedDateZonesAOuse base flood depth06016200508232001X45300
B10 Indicate the source of the Base Flood Elevation BFE data or base flood depth entered in Item B9
FIS Profile FIRM Community Determined Other Describe
B11 Indicate elevation datum used for BFE in Item B9 NGVD 1929 NAVD 1988 Other Describe NAB12IsthebuildinglocatedinaCoastalBarrierResourcesSystemCBRSareaorOtherwiseProtectedAreaOPA Yes NoDesignationDateCBRSOPA
SECTION C BUILDING ELEVATION INFORMATION SURVEY REQUIRED
01 Building elevations are based on Construction Drawings Building Under Construction Finished Construction
A new Elevation Certificate will be required when construction of the building is complete
C2 Elevations Zones A1A30 AE AH A with BFE VE V1 V30 V with BFE AR ARA ARAE ARA1 A30 ARAH ARAO Complete Items C2a hbelow according to the building diagram specified in Item A7 Use the same datum as the BFE
Benchmark Utilized ELEV 47206 Vertical Datum NGVD 1929
Conversion Comments BM PROVIDED BY HALF ASSOCIATES Inc
Check the measurement used
a Top of bottom floor including basement crawlspace or enclosure floor 46227 feet meters Puerto Rico only
b Top of the next higher floor N A feet meters Puerto Rico only
c Bottom of the lowest horizontal structural member V Zones only N A feet meters Puerto Rico only
d Attached garage top of slab N A feet meters Puerto Rico only
e Lowest elevation of machinery or equipment servicing the building N A feet meters Puerto Rico onlyDescribetypeofequipmentandlocationinComments
f Lowest adjacent finished grade next to building LAG 46087 feet meters Puerto Rico only
g Highest adjacent finished grade next to building HAG 46117 feet meters Puerto Rico only
h Lowest adjacent grade at lowest elevation of deck or stairs including N A feet meters Puerto Rico onlystructural support
SECTION D SURVEYOR ENGINEER OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor engineer or architect authorized by law to certify elevationinformationcertify that the information 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 US Code Section 1001
Check here if comments are provided on back of form Were latitude and longitude in Section A provided by a
licensed land surveyor Yes No
Certifiers Name BARRY RHODES License Number 3691
Title OWNER RPLS Company Name RHODES SURVEYING
Address 7509 PENNRIDGE CIRCLE City ROWLETT State TX ZIP Code 75088
Signature Date 3242011 Telephone 972 475 8940
FEMA Form 81 31 Mar 09 See reverse side for continuation Replaces all previous editions
IMPORTANT In these spaces copy the corresponding information from Section A for Ir Sura orpay UBuildingStreetAddressincludingAptUnitSuiteandorBldgNoorPORouteandBoxNoisjp608INGLENOOKCOURT
gCityCOPPELLStateTXZIPCode75019
SECTION D SURVEYOR ENGINEER OR ARCHITECT CERTIFICATION CONTINUED
Copy both sides of this Elevation Certificate for 1 community official 2 insurance agentcompany and 3 building owner
Comments BENCHMARK RR SPIKE FOUND IN THE NORTH SIDE OF POWER POLE AT SOUTHWEST CORNER OF CICERO LONGS LOT AND
NORTH SIDE OF DEFOREST ROAD SOUTHEAST CORNER OF THE ESTATES OF CAMBRIDGE MANOR ADDITION INFORMATION RECORDED INWINDSORESTATESADDITIONRECORDEDINVOLUME2001077PAGE 2283 OF THE MAP RECORDS DALLAS COUNTY TEXAS
Signature Date 3242011
Check here if attachments
SECTION E BUILDING ELEVATION INFORMATION SURVEY NOT REQUIRED FOR ZONE AO AND ZONE A WITHOUT BFE
For Zones AO and A without BFE complete Items E1 E5 If the Certificate is intended to support a LOMA or LOMR F request complete Sections A BandCForItemsE1E4usenaturalgradeifavailableCheckthemeasurementusedInPuertoRicoonlyentermeters
E1 Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacentgradeHAGandthelowestadjacentgradeLAG
a Top of bottom floor including basement crawlspace or enclosure is N A feet meters above or below the HAGbTopofbottomfloorincludingbasementcrawlspaceorenclosureisNAfeetmetersaboveorbelowtheLAG
E2 For Building Diagrams 69 with permanent flood openings provided in Section A Items 8 andor 9 see pages 8 9 of Instructions the next higher floorelevationC2binthediagramsofthebuildingisNAfeetmetersaboveorbelowtheHAG
E3 Attached garage top of slab is N A feet meters above or below the HAG
E4 Top of platform of machinery and or equipment servicing the building is NA feet meters above or below the HAG
E5 Zone AO only If no flood depth number is available is the top of the bottom floor elevated in accordance with the communitys floodplain managementordinanceYesNoUnknownThelocalofficialmustcertifythisinformationinSectionG
SECTION F PROPERTY OWNER OR OWNERS REPRESENTATIVE CERTIFICATION
The property owner or owners authorized representative who completes Sections A B and E for Zone A without a FEMA issued or community issued BFEor Zone AO must sign here The statements in Sections A 8 and E are correct to the best of my knowledge
Property Owners or Owners Authorized Representatives Name
Address City State ZIP Code
Signature Date Telephone
Comments
Check here if attachments
SECTION G COMMUNITY INFORMATION OPTIONAL
The local official who is authorized by law or ordinance to administer the communitys floodplain management ordinance can complete Sections A B C or EandGofthisElevationCertificateCompletetheapplicableitemsand sign below Check the measurement used in Items G8 and G9
G 1 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor engineer or architect whoisauthorizedbylaw to certify elevation information Indicate the source and date of the elevation data in the Comments area belowG2AcommunityofficialcompletedSectionEforabuilding located in Zone A without a FEMA issued or community issued BFE or Zone A0
G3 The following information Items G4 G9 is provided for community floodplain management purposes
G4 Permit Number G5 Date Permit Issued G6 Date Certificate Of Compliance Occupancy Issued
G7 This permit has been issued for New Construction Substantial Improvement
G8 Elevation of as built lowest floor including basement of the building feet meters PR Datum
09 BFE or in Zone AO depth of flooding at the building site feet meters PR Datum
G10 Communitys design flood elevation feet meters PR Datum
Local Officials Name Title
Community Name Telephone
Signature Date
Comments
Check here if attachments
FEMA Form 81 31 Mar 09
Replaces all previous editions
Building Photographs
See Instructions for Item A6
Building Street Address including Apt Unit Suite and or Bldg No or PO Route and Box No 4C608INGLENOOKCOURT
City COPPELL State TX ZIP Code 75019 CarpBny NALCNumbef
If using the Elevation Certificate to obtain NFIP flood insurance affix at least two building photographs below according totheinstructionsforItemA6IdentifyallphotographswithdatetakenFront View and Rear View and if required RightSideViewandLeftSideViewIfsubmitting more photographs than will fit on this page use the Continuation Page on thereverse
FRONT VIEW 3242011
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