FEMA-EC940329® 1qdgg113 r y 0, -Lq
The City With A Bea ut iful Future BUILDING PERMIT APPLICATION
Building Inspections Division D �
/ji�/� J Z 1 Print or Type in a Clear, Legible Manner
Job Address:�Q � O
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Date:
3 }
Lot: Block: Subdivision: a / hs G.d Phase or Section Number: /
Owner: Address:
A 0-'- 3 o,. ,/ 0 v
Phone #:
O
3 3_O O % %
Contractor: Address: S-' e- /l
0e'11,'!5T
Phone #:
75-06
Description of Work to be Done Class of Work: &'New ❑Addition
❑ Alteration
❑ Repair ❑Demolition
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Area of Building in Square Feet
First Floor -1712 Garage s`
Second Floor � � Other �,3 3
Value of Work C�b
to be Performed 2 / � Ob
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee: azQ,i
Receipt Number. 3
Zoning District:
Occupancy Classification:
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
days at any time after work is commenced.
Approved By:
Date:
I hereby certify that I have read and examined this application and know the same to be true
Comments:
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.
Joe
igneture of Contractor or Authorized Agent Print
NName
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Pp4 4e -j- CI�-e { aw c P4•tGLA, 0 /.1 i
Electrical Contractor Plumbing Contractor Mechanical Contractor
BIR - 1 12/82)
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CONC.
DRIVE CONC. WALK
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CITY -SIDEWALK
9 7 0 L A C U N A D R I V E
SITE PLAN N 0 RTH
SCALE: 1 "=20'0" LOT— 8, BLOCK -- A.
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EXIST. MAINTENANCE &
ACCESS SMT. TO LAKES OF EXISTING LAKE
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COPPELL OWNER'S ASSOC.
VOL. 85233 PG. 3426
PROPOSED 100 YEAR
FLOOD PLAIN LIMIT
15.79'
17.12'
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9 7 0 L A C U N A D R I V E
SITE PLAN N 0 RTH
SCALE: 1 "=20'0" LOT— 8, BLOCK -- A.
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ELEVATION CERTIFICATE 0 A 6No 30t-7 00
FEDERAL EMERGENCY MANAGEMENT AGENCY fAPIresM,,y;1, 1993
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 necetsary to ensure compliance with applicable community floodplain management ordinances, to
determine the proper insurance premium rale, 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
Dun INU UWNER'S NAME
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
.97D LAQUAIA. L.449 --
OTHER DESCRIPTION (Lot and Block Numbers. etc.)
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
I. COMMUNITY NUMBER
4�ono
2. PANEL NUMBER I 3. SUFFIX 4. DATE OF FIRM INDEX
10
I
FOR INSURANCE COMPANY USE
POLICY NUMBER
COMPANY NAIC NUMBER
ZIP CODE
5. FIRM ZONEI 6. BASE FLOOD ELEVATION
(gin AO Zones. use depth)
161 i%ML%
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '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::- ! ! ! _-I _.j.LJ 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 4-017-M2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top is at an elevation
Of --_ z - I $ 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-L.L UJ.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 UJ." 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 L-1_).0 feet above ❑ or below D (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
leve() elevated in accordance with the community's floodplain management ordinance? ❑ Yes [, No
n Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: 0 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 71, 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 F
IR ❑ Yes F] No (See Instructions on Page 4
) L4r1kr%0WtJ
S. The reference level elevation is based on: tual construction ❑ construction drawings Of 4:Oe M'j
(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 elevatiori'of the lowest grade immediately adjacent to the building is: I I I I J.0 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_] 1. 1 1_1.0 feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31s 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 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 SFE), 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 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.
1 certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME
TITLE
ZI
ADDRESS
LICENSE NUMBER (or Affix Seal)
COMPANY NAME
CITY
STATE ZIP
�./„E. . •� � � .�.-� � �y r yy-- ZI4 � X42-�4�
SIGNATURE DAT PHONE
Copies should be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner.
COMMENTS:
NOTE:
This "Elevation Certificate” is valid for item 2(a) only and in so much as changes made on the
face of this document. This is a certification of elevation of form boards only.
Tt
The property referenced hereon is not located in a FEMA 100 year flood hazard as per referenced
— panel
The elevations shown were taken from grading plan of Waters Edge Addition.
ON WITH ON PILES,
SLAB BASEMENT PIERS. OR COLUMNS
A V A A v
ZONES ZONES ZONES7 ZONES ZONES
REFERENCE REFERENCE
IEVEI BASE IEVEI
REFERENCE
FLOOD
LEVEL
ELEVATION
BASE :' ::;;`.I`' ,
FLOOD ADJACENT.:' "'d� REFERENCE
BASE
:: i;;
ELEVATION gEFERENCE ADJACENT GRADE ai LEVEL
FLOOD
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
r
BLOCK
SURVEY PIAT
ADDRESS: 970 LAGUNA LANE, COPPELL, TEXAS.
LOT 8, BLOCK A, WATER'S EDGE, COPPELL, TEXAS.
LAKE
PROPOSED 100 YR.
FLOOD
LAGUNA LANE
N 31°08'13"E
2d MAINTENANCE
5 ACCESS ESMIT.
VOL.85233, PG. 3426
ILDT 7
A
i
} 101 UTILITY ESM`f
TO: THE PROPERTY SHOWN HEREON IS NOT LOCATED IN A DESIGINATED
AVERY & EDWARDS ZONE A (100 YEAR FLOOD HAZARD AEA) ACCORDING TO FEMA MAP:
PROPERTY 13 LOCATED IN ZONE:
PANEL : 14801 0 0010 D DATED: IO -1(o 91
1 do hereby certify that the plat shown hereon represents the results of a survey made on the ground by
me or under my direction and supervialon. visible and apparent Improvements to the property found on the
ground are shown hereon. Except as shown hereon there were no visible and apparent encroachments or OF
protrusions of Improvements found on the ground. This survey is subject to all easements of record.
This survey was performed exclusively for the above mentioned parties. Use of this survey for any other ,.• $ T +
purpose or by others shall be at their risk. �14;'�G t FRF++ y
SHIELDS AND LEE SURVEYOR "j�
.................:.....
W. R. LEE �
SCALE l II _ ZO.
DATE 3 - Z3 -N
JOB NO. 98105
DRAWN BY C.P
1421 FERNDALE AVENUE
DALLAS, TEXAS 75224
(214) 942-8496
.............................
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W.R. Lee, RPI -S 2038