FEMA-EC940621® w M# 7Ya5l3 d 5 R 5, z*'L-
he City With A S"utitul Future BUILDING PERMIT APPLICATION
T
7Building Inspections Division
IQ �'2). 2 "I Print or Type in a Clear, Legible Manner
Job Address:
Date:
APR 2 2 214
Block: Subdivision:
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Phase or Section Number:
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Owner:C A2C.ddress:
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LPhone #: S?3
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Contractor:f ':f�A`46� Address:
Phone #:
and correct. All provisions of laws and ordinances governing this type of work will be
complied with whether specified herein or not. The granting of a permit does not presume to
Description of Work to be Done Class of Work: New
�l'i�✓�'� Aj�?Inlz y
❑Addition
❑ Alteration ❑ Repair
❑Demolition
#73 Z5
of Building in Square Feet "1-711
First Floor �d Garage
Second Floor /0,5— Other
NOTICE
Pe
This permit becomes null and void if work or construction authorized is not commenced
within 180 days, or construction on work is suspended or abandoned for a period of 180
ZO
days at any time after work is commenced.
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I hereby certify that I have read and examined this application and know the same to be true
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and correct. All provisions of laws and ordinances governing this type of work will be
complied with whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction or the performance of construction.
Signature of Contracto or Authoriz Agent �CPrint NName
.110
CY ltrj/ �l
Electrical Contractor Pl a Co tractor Mechanical Contractor
BIR - 1 (2/82)
a
Value of Work
to be Performed
GRAY AREA FOR OFFICE USE ONLY
ELEVATION CERTIFICATE ExpiresNo May3 ,1993
Expires May 31, 1993
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 LOMB).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POLICY NUMBER
CouAIMy 6�«N AvMEs
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
'7.550 LA G u Al,* vQ t vE-
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
LoT /1 1 BI K A GyeEDS PAN4SE L,�it/E �O PPgLL OA2L1+S CvUA) TY 1 TX
CITY Ct
f PeR,L
Tx ZIP CODE
/` %S
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
S. FIRM ZONE6.
BASE FLOOD ELEVATION
�a a 70
oa J Q
D
o 0-0869r)% of
X
(in AO Zones, use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ZNGVD '29 ❑ Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE: 1 1 Aslo .1-15-1 feet NGVD (or other FIRM datum–see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicat the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level T .
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 LAI X15131.L!� 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 I I I I I .0 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 W .0 feet above ❑ or
below ❑ (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 . U 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 ❑ 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 8, Item 77, 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 �FIIR/M: 1:1 Yes L`� No (See Instructions on Page 4)
5. The reference level elevation is based on: L� 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: l lei s�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: I I I I I I .0 feet NGVD (or other FIRM datum–see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 90 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 13FE),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, aria use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data a OF
606 .
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 10 �t A. T
CER'iIFIER'S NAME LICENSE NUMBER (or Affix Seal) •«••••••«•••••••.••.•....
ffft1UL.6,6-
TITLE COMPANY NAME •.
SUR
ADDRESS CITY STATE ZIP
SI
DATE
2- r -q4 P"Nb 7 -T E-104, '
Copies should be made o this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE
LEVEL BASE LEVEL
REFERENCE
FLOOD
LEVEL
ELEVATION
ir$': :..,.... .. kik;:.:. „,lid •f,.
•.'.'.v:::'i.
:;:::.: '..:;`.:.•. : `-::
BASE
FLOOD ADJACENT: ;• REFERENCE
BASE
FLOOD
ELEVATION REFERENCE ADJACENT GRADE LEVEL
ELEVATION
LEVEL GRADE
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
DESCRIPTION
Beim Lot 11, 131o( -k A. of WATERS EDGE PHASE ONE, an Addition to the City of Coppell,
Dallas Count%, Te,,as, aceordiuh to the Map thereof rec•orde(1 iu Volume 4)2'_''8. Page,
3869, Deed Record,,, Dallas Couut v. Texas.
!COTE: Aceordinh to F.E.M.A. Flood Insurance Kale Map. Colrinrunit c Pallel 'No. 480170 00101),dated Oct. 16' 19,91 this property lids in Zor►e v Thi, prohert.N dote not appear to lie
Within a 100-- var flood plaits.
Exis iin9 L oke t�Ai `1
Lakes of Coppel v2,�
Owners Association �� . / Exit 20'Wintenome t
A llc CO Coppet) Esnt. Lake
c �� Q of Owar's Assoc.
�C) V01.85233 Pp.3426
•ll"W�/�
Lor 12
HAROLD D. FETTY III
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60
N/0°24 47-E
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Sand Stone
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N01 "28 ' 37 `E Fnd X
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Tele. Utility Esnt.
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R - 345. 00
L -24. 42
L oc tuno Drive
Per C Ordinance No. 93610
I, Harold 1). potty, III, Re-istvred Professional Land �urveNor. '4tate of '1'exus, cto ccrtif,,
that the pleat hereou is7atrue, correct acid .iccurate rripresctitatiori of the propert.y
as determined h,, surNel• perforuued on tlic ground, the lines and dimensions of said
propert ti being indicates) h� t}ee plat, t tee irnpro�enrents are within the bocrndarie of
the pro iert N, set back front the property C'
lines the dist ar►t es indicated and there aro , 1�1 ALF � a�EMEtiTtiHE
, EN(�P0A(•MlTS, ONFIACT5 I'
OP ROTht SIONS, except a, showri
oil the aho%r plat.
9toy-
Harold 1). Fvtt 4.111 IZ. .L.�. �o. 5014
S TO VA L& A SSOCIA TES. INC. SURVEYORS
*,— 6210 CAtMPM1 ROM, SUITE 144 a DALLAS, TEXAS 75248 0 PHONE (214) 407-1044 ■