FEMA-EC940706CKYWith AB"utftlFut" BUILDING PERMIT APPLICATION
Building Inspections Division
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'j . .-1 Print or Type in a Clear, Legible Manner
JUN 0 9 94
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IJob Address: /'5-4vd1 Date: <-Zl-y/y.5! I
Lot: SL? Block: Subdivision: _ Phase or Section Number:
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Owner: Address: « /Gs��Phone:�.StJ
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Contractor: Address: Phone 11:l;9A*V 1171—.Z7! 9
Description of Work to be Done Class of Work: ffNew ❑Addition ❑ Alteration ❑ Repair ❑Demolition
. jArea of Building in Square Feet
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35, RYD.
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AJ Z/ <ING5r-'llLL v LOT 41
51DEW " L< 45 f='=R CIT1- REQ. BLOCK A
F4.1-1 -IN 15T 10' F41f;PWA-1-5 OF RvEIRGH,45E
P - EL5EU)1�4=-RE GOPPELL Tx
/ASITE
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E3iRNETT RESIDENCE
PLAN &,4N0QTP I"=20' 94310 I
-Ts &- PLANNERS
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AS
(2 14) 248— 3015
• O.M.& NO. 9067.0077
ELEVATION CERTIFICATE ExpiresMay,31,1996'
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.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POLICY NUMBER
STR R S Includin A t. Un Suite d/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
��'� i�gsZi� l �our�
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
Lot 47, Block A FAIRWAYS OF RIVER CHASE
CITY STATE ZIP CODE
Coppell Texas
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructio;Is):
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BA6E FLOOD ELEVATION
(in AO Zones, use depth)
480170
1
C
2-15-84
AE
443
Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 [ _J Other (describe on back)
3. For Zones A or V, where no BFE is provided or the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE:' i_.__'.._' _. 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 __— .
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 [.1 4491-Q ❑ 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 1 1 L_LJ .❑ 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 ❑-.LI feet above ❑ or
below El (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 1 1I.❑ 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 [:1 No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:] 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 7], 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: [2*Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: ❑ 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: I I I I I.❑ .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: j I I I I I .❑ feet NGVD (or other FIRM datum–see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 51-31, MAY 93 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 -Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, 11, mu OR tend.
I certify that the information in Sections B and C on this certificate represents my best effort IF
k
ffable.
i understand that any false statement may be punishable by fine or imprisonment under 1
CERTIFIER'S NAME LICENSE NUMBER (328'"
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TITLE COMPANY NAME Q •��NNt�
THOMAS W. VOGT, REGISTERED PROFESSIONAL LAND SURVEY Suit
ADDRESS CITY sTTex*3S 7ATE 609595
P.O. Box 210 74 Bedford
RE DATE PHONE
SI NATURE
July 6, 1994 (817)284-1621
Copies should be made of this Certifi ate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS: __ - — —
* F.T.EVAT ION - TOP OF FORMBOARD
Page 2
WITH ON PILES,
ON
BASEMENT PIERS, OR COLUMNS
SLAB
A v
A A V
ZONES ZONES ZONES
ZONES ZONES
REFERENCE
LEVEL_J
REFERENCE
REFERENCE
LEVEL
BASE
FLOOD
ELEVATION
LEVEL
I
`.
BASE
BASE •
FLOOD
ELEVATION REFERENCE ADJACENT
'..: i i:i'i'a :.; a
ADJACENT ':.'''>'' REFERENCE
GRADE LEVEL
FLOOD
ELEVATION
LEVEL GRADE',
:;•'ii ''.:ii:::•
.
ADJACENT.:
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
SURVEY PLAT
ADDRESS: 1504 Kingsmill Court, COPPELL, Texas.
LEGAL: Lot 47, Block A, FAIRWAYS OF RIVER CIIASE, an Addition to the City of Coppell, Dallas County,
Texas, according to the Plat recorded in Volume 93056, Page 2367, Plat Records, Dallas County, Texas.
C�❑UF S❑URS❑
S 890 32'43" E
80.43'
— — EXISTING GOLF COURSE LANDSCAPE ESMT,
3'T2�SR�- --__PER VOL 87174,PG3438 r
ROCK WALL 1/2' S.R.F.
L_DT 48 LCAT 47
BLOCK A
11,560 SF L ❑ T 46
W 14.51
20.2' 1
N ("; , N
?0 '� N
8.01
FORMBOARDS O
ONL Y cr) r
TOP OF FORM 7
ELEV. 449.23'
1
x,10.0'
25' BLDG LINE
C1
_-----_ _0) N
10TIL ES
SAF I MT. Per plat VOL 93056, PG 2367 — — —
80 '
0,1
N 83° 37' 31" W . 1/2" S.R.F.
BEARING BASE PER PLA T
1504 KING
MILL ►O
UR T - --
DATE: 07-06-1994
SURVEY NO.! 9.100787
SCALE: I inch = 20 feet The undersigned does hereby certify that this survey was this day made on the ground of the prpperty legally described
hereon and is correct, and that there are no discrepancies, conflicts, encroachments, overlapping of improvements,
visible easements or rights of way, except as shown hereon, and that said property has access to and from a dedicated
roadway. Sad property being subject to any and al easements, reservations and restrictions that may be of record.
Any referenc y�0 year flood plain or flood hazard zones are an estimate based on data shown on the Flood
Insuranc y HUD and should not be interpreledl as a study or deterrrinption the flooding
or of pr i
LEGEND
D STEEL ROD FOUND
t STEEL ROD SET
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THOMAS W. OGT, P.E.
PROPERTY LINE
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REGISTERED PROFESSIONAL LAND SURVEYOR NO. 1928
WOOD FENCE
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POWER POLE
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REGISTERED PROFESSIONAL ENGINEER NO. 45622
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SS'V�fiy
P.O. BOX 210274 • BEDFORD, TEXAS 76095-7274
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OVERHEAD ELECTRICAL LINES
CONCRETE
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S1lR
UR
PHONE: (81 7) 284-1621 a FAX: @I7 589.1278
COPYRIGHT 1994 BY THOMAS W. VOGT