FEMA-EC051011O.M.B. No. 3067-0077
Expires December 31,2005
BUILDING OWNER'S NAME
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE pROGRAM
ELEVATION CERTIFICATE
Important: Read the instructions on p~es 1- 7.
SECTION A- PROPERTY OWNER INFORMATION
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No~) OR P.O. ROUTE AND BOX NO.
629 iNGLENOOK COURT IFor
Insuranre Company Use:
Policy Number
Company NAIC Number
CITY STATE ZIP CODE
COPPELL TX 75019
PROPERTY DESCRIPTION (Lot and Block Numbem, Tax Parcel Number, Legal Deacdption, etc.)
LOT 17 BLOCK A ST. ANDREWS ESTATES
BUILDING USE (e.g., Residentiat, Non.residential, Addition, Accessory, etc. Use a Comments area, if necessary)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL)
f~'' or ~.;,';ll,';.'.?'~)
HORIZONTAL DATUM:
NAD 1927 E] NAD 1983
SOURCE: [] GPS (Type):
USGS Quad Map Othen FIRM
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1 NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME !, I B3 STATE
COPPELL 480170 DALLAS I TEXAS
84 MAP AND PANEL 87. FIRM PANEL
NUMBER 85. SUFFIX 86. FIRM INDEX DATE EFFECTIVE/REVISED DATE 88. FLOOD ZONE(S)
48113C0155 J 06-16-2005 1001-2003 X, AE
810 Indicate ~he source OF the Base Fldod Elevation (BFE) data or base flood depth entered in 89.
FIS Profile [] FIRM [] Communily Determined [] Other (Describe):
B11 Indicate the elevation datum used for the BFE in Bg: [] NGVD 1929 r-i NAVD 1988 [] Other(Describe):
B12~sthebuild~oua~edinaC~astelBa~erRes~urcesS)`stem~CBRS~areaor~the~sePreteatedArea~PA)? []Yes [~]No Desi~lna~Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
c1 Building elevations are based on: [] Construction Drawings* [] Building Under Constru~on* [] Finished Construction
A new Elevation CerlJficate will be required when construction of the building is oumplete
C2. Building Diagram Number _1 (Se~ectthe building diagram most similar to the building for which ~his certificate is bang completed - see pages 6 and 7. if no diagram
accurately represents the building, provue a sketch or photograph.)
C3. Elevations - Zones A1A30, AE, AH, A (with BFE), VE, V1 -V30, V (w~h BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO
Complete Items C3.-~ below according to the building diagram speafied in Item C2. State the datum used. If the datum is d~a'eef from the datum used for the BFE in
Section B, conved the datum to that used for the BFE. Show field measurements end datum conversion ~culation Use the space provided or the Corements area of
Section D or Section G, as approFiate, to document the datum conversion
DatumNGVD1929 Conversion/CEmrr~qts BM PROVDED ON RECORD PLAT DEFOREST COURT BY HALFANDASSOC.
Elevation reference mark used Does the elev~on reference mark used appear on the FIRM? :~ Yes [] No
Bg. BASE FLOCO ELEVATION(S)
Zone AO, use depth of fo~ding)
453.0
1 a) Top of bottom floor (including basement or enclosure)
b) Top of next higher floor
Q c) Bottom of lowest hodzontel structural member (V zones only)
1.2, d) Attached garage (top of slab)
F_..I e) Lowest elevafico of machinery and/or equipment
servidng the building (Describe in a Comments area)
F.J 0 Lowest adjacent (finished) grade (LAG)
F__I g) Highest adjacent (finished) grade (HAG)
456. 33 ft(m)
456.79 fl.(m)
NA. __ft.(m)
N2 __ft(m)
NA..ft.(m)
452,20 ft,(m)
455. 79 ft.(m)
O h) No of permanent openings (flood vents) within 1 ft. above adjacent grade NA
1 i) Total area of all permanent openings (ftood vents) in C3.h NAsq. in. (sq. cra)
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/nterpret 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 BARRY RHODES LICENSE NUMBER 3691
TITLE OWNER
ADDRESS
FEMA Form 8~ry 2003
COMPANY NAME BARRY RHODES
CITY STATE
ROWLEFD TX
ZIP CODE
75088
DATE TELEPHONE
10-11-2005 972-475-8940
See reverse side for continuation.Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A.
6UILOING STREET ADDRESS (Including ApL, Unit Suite, and/or B~. No.) OR P.O. ROUTE AND BOX NO.
529 INGLENOOK COURT
CITY STATE ZIP C00E
COPPELL TX 75019
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED
Copy both sides of this Elevation C~ficate for (1) community official, (2) ir,;surance agent/company, and (3) building owner.
For Insurance Cornpany Use:
Pol~ Number
Company NAIC Number
COMMENTS
Check here if attachments
SECTION E · BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AD AND ZONE A ¢/VITHOUT BFE)
For Zone AD and Zone A (without BFE), complete Items E1 through E4. if the Elevation Cettiflcate is intended for use as suppoding informe~en for a LaMA or LOMR-F,
Section C must be completed.
E1 Building Diagram Number _(Setsct the building diagram most similar to the building for which this cettifcate is being completed- see pages 6 and 7 If no diagram accurately
represents the building, provide a sketch or photograph,)
E2 The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m)_in,(cm) [] above or [] b~ow (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 aevated'~or (elevelJon b) of the building is _ ft.(m)_in,(om} a~3ve 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 serviQng the building is _ ft,(m)_in(om) [] above or [] below (check one) the highest adjacent grade. (Use
natural grade, if available)
E5 For Zone AD only: If no flood depth number is availaUe, is the top of the bottom floor elevated in aecordahce with the community's floodplain management ordinance?
Yes [--~No []Unknown. Thelocaloftic~elmustcertiffthisinformaDoninSestionG
SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owneKs authodzed representative who completes Sections A. B, C (Items C3.h and ~3.i only), and E for Zone A (without a FEMAqssued or community-
issued BFE) or Zone AD must sign here. The statements in Sections A, B, C, and E are correct to the best~f my knowledge.
PROPERTYOWNE~SOROWNE~SAUTHORIZEDREPRESENTATIVE'S NAME
ADDRESS CITY ~' STATE ZIPCOBE
SIGNATURE DATE TELEPHONE
COMMENTS
Check here if attachments
SECTION G - COMMUNffY INFORMATION (OPTIONAL)
The tucal officiaJ 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
Cedif~cate Complete {he applicable item{s) and sign below.
G1 [] The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, enCnser, or architect who is authorized by state
or Iocel law to certif7 elevation information. (indicate the soo[ce and date of the elevaifon data in the Comments area below)
G2 [] A community offdel completed Section E for a building located in Zone A (without a FEMA-issued or community4ssued BFE) or Zo~ AD
G3 [] The follOW~ng ioforma~n (Items G4~9) is provided for community floodplain management purpose~;
G4. PERMIT NUMBER G5. DATE PERMrT ISSUED ~. DATE CERYiFiCATE O~ COMPLIANCE/OCCUPANCY ISSUED
G7 This permit has been issued for: [] New Construction [] Substantial ~mprovement
GB, Elevation of as-built lowest floor (induding basement) of the buikJing is: __, _ft,(m) Datum:
G9 BFE or (in Zone AD) depth of flooding at the building s~te is: __, _ ~,,(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
Check here if attachments
FEMA Form 81-31. January 2003 Replaces all previous editibns