FEMA-EC050708l ~ I
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
O.M.B. No. 3067-0077
Expires December 31, 2005
ImDOrtant: Read the instructions on D80es 1 .7.
SECTION A. PROPERTY OWNER INFORMATION For Insurance Company Use:
UILDING OWNER'S NAME Policy Number
BUILDING STREET ADDRESS (Including Apt., Un~, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
612 INGLENOOK COURT
CITY STATE
COPPELL TX
jPROPERTYDESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.
LOT 3 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:
NAD 1927 0 NAD 1983
SOURCE: 0 GPS (Type):_
o USGS Quad Map Other: FIRM
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME & COMMUNITY NUMBER I 82. COUNTY NAME 83. STATE
COPPELL 480170 DALLAS TEXAS
84. Ml\P AND PANEL B7. FIRM PANEL 89. BASE FLOOD ELEVA TION(S)
NUMBER 85. SUFFIX 86. FIRM INDEX DATE EFFECllVE.REVISED DATE 86. FLOOD ZONE(S) (Zone AD, use depIh of lIlodiC9)
48113COl55 J ()8.()4-2004 1M1.2004 X, NA
B10.lndicate the SOUral of the Base Flood EJevatioo (BFE) data or base flood depth entered in B9,
o FIS Profile IZI FiRM 0 Community Determined 0 Other (Describe):_
B11.lndicatethe elevation dalum used for the BFE in 89: IZI NGVD 1929 0 NAVD 1988 0 Other (Describe):_
B12.ls the building located in a Coastal Barrier Resources System (CBRS) area or Othmv.;se Protected Area (OPA)? 0 Yes IZI No Designation Date
SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Builrnng elevatioos "" based 00: 0 Construdioo Drawings' IZI Builrnng Under Construdioo' 0 Finished Construction
A new Elevation Certificate will be required when construdioo of the building ~ complete.
C2. Building Diagram Number 1 (Select the building diagram most ~milar to the building for wh~h this certificate ~ beng completed - see pages 6 and 7. If no diagram
accurately represents the building, pro~de a sketch or photograph,)
C3. Elevations - Zones A 1-A30, AE, AH, A (w~ BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARIA 1-A30, ARlAH, ARlAO
Complete Items C3.-aj 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 conversioo ca~ulatioo. Use the space provided or the Comments area ot
Section D or Sectioo G, as appropriate, to document the datum conversion.
Datum NGVD1929 Conversion/Comments BM PROVIDED ON RECORD PLAT DEFOREST COURT BY HALF AND ASSOC.
Elevation reference mark used _Does the elevation reference mark used appear 00 the FIRM? 0 Yes IZI No
o a) Top of bottom floor (inclurnngbasementorendosure) 457. 22ft.(m)
o b) Top of next higher floor 459.lLft.(m)
c) Bo~om of lowest honzontal structural member (V zooes only) NA '_ ft.(m)
d) Attached garage (top of slab) 459. lLft,(m)
o e) Lowest eievation of machinery and/or equipment
servdng the building (Describe in a Comments area) NA. _ft.(m)
o D Lowest adjacent (finished) grade (LAG) 456 , 02 ft.(m)
o g) Highest adjacent (finished) grade (HAG) 450. lift.(m)
o h) No. of permanent openings (flood vents) ..thin 1 ft. above adjacent grade NA
i)iotal area of all permanent openings (flood vents) in C3,h tJA.sq. in. (sq. em)
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 elevation 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 that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFiERS NAME BARRY RHODES LICENSE NUMBER 3691
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TITLE OWNER COMPANY NAME BARRY RHODES
ADDRESS
7509 PENNRIDGE CI
SIGNA TU
CITY
ROWLETT
DATE
07-08-2005
FEMA F See reverse side for continuation.
ZIP CODE
75088
STATE
TX
TELEPHONE
972-475-<3940
Replaces all previous editions
IMPORT ANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
BUILDI!~S 3TREET ADDRESS (Including Apt., UnIT, Suite, and/or Bldg, No,) OR P,O, ROUTE AND BOX NO, Policy Number
612 INGLENOOK COURT
Company NAIC NumberCITYSTATEZIPCODE
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) building owner.
COM~NTS
o 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 (without BFE), complete Items E1 through E4, If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed,
E1.
Buildiri9..
Diagram Number _(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
presents the building, provide a sketch or photograph,)
E2, The top of the bottom floor (including basement or enclosure) of the building is _ It,(m) _in.(cm) D above or D below (check one) the highest adjacent grade, (Use
natural grade, if available).
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated flcor (elevation b) of the building is __ It.(m) _in.(cm) above the highest adjacent
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 _ It.(m) _in.(cm) D above or D below (check one) the highest adjacent grade, (Use
natural grade, if available).
ES, For Zone AO only: If no flood depth number is available, is the top of the bottom flcor elevated in accordance with the community's floodplain management ordinance?
DYes 0 No 0 Unknown, The local official must certify this information in Section G,
SECTION F . PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3,i only), and E for Zone A (without a FEMA-issued or community-
issued BFE) or Zone AO must sign here, The statements in Sections A, B, C, and E are correct to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
o Check here if attachments
SECTION G. COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized 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
Certifica~e Complete the applicable item(s) and sign below.
G 1, [J The information 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 elevation information, (Indicate the source and date of the elevation data in the Comments area below.)
G2, 0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.
G3. 0 The following information (Items G4-G9) is provided for community floodplain management purposes.
G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
It.(m)
ft,(m)
Datum:
Datum:
SIGNATURE
COMMENTS
TITLE
TELEPHONE
DATE
o Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions