FEMA-EC960924® c 31, i3
The City With A BeautifUl Future BUILDING PERMIT APPLICATION
A0
n n A 1 'rflti
of Building in Square Feet
First Floor ,=
Second Floor \\�
NOTICE
Garage
Other
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
I hereby certify that I have read and examined this application and know the same to be true
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.
(-N N �I^ ("'-. _V,-"
Signatike of Contractoror Authorized Agent Print Name
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC -1 (4/94)
Value of Work
to be Performed���
Y AREA FOR OFFICE USE ONLY
Print or Type in a Clear, Legible Manner
Job Address:
Date:
Lot: Block:
Subdivision:
Phase or Section Number:
Address:
N: �L
Contractor:
Address:
Phone #:
Description of Work to be Done
Class of Work:
` New
[]Addition ❑ Alteration ❑ Repair [:]Demolition
of Building in Square Feet
First Floor ,=
Second Floor \\�
NOTICE
Garage
Other
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
I hereby certify that I have read and examined this application and know the same to be true
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.
(-N N �I^ ("'-. _V,-"
Signatike of Contractoror Authorized Agent Print Name
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC -1 (4/94)
Value of Work
to be Performed���
Y AREA FOR OFFICE USE ONLY
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PLAT SHOWING
LOT 18, in BLOCK E, of EAGLE POINT VLLLAGE
at RIVERCHASE, an Addition to the City of
Coppell, Dallas County, Texas, according
to the Map or Plat thereof recorded in Jam.
Volume 93055, Page 43, Map Records, Dallas
County, Texas.
Commonly known as 128 Longmeadow Drive.
x (5ussa�Eo�, lam'
THIS PROPERTY IS LOCATED IN ZONE (S)E AS DELINEATED ON FLOOD INSURANCE RATE MAP
PANEL NO. AS01-10 oo►o E EFFECTIVE DATE ARE -AL- 5- 12024 . LOCALIZED FLOODING
NOT DETERMINED.
P. 0. Box 13556 • Land Surveying
Arlington, Texas • Land P%wWng
GEODATA SURVEYING, INC. 76094-0556 • Topographic
Metro 261.2878 Mapping
or �. I hereby Certify this to be a true and oorrect representation of a
SCALE I z 241 �! �0 * 40o+ -v survey made on the ground under my supervision and there are
no ' 'ble encroachments or protrusions except as shown.
GLENN W. MILLER
LEGEND "".."" 01
fat 223fp GLENN W. MILLER R.P.L.S. - STATE OF TEXAS NO. 4223
o ....... iron rod
—x --x . — ...... fence line �� It 111► �' DATE 2 • 2-4 '~G
T— —E— — utility line
O.M.B. NO. 3067-0077
ELEVATION CERTIFICATE,.Expires May 31,1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate dogs 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.
BUILDING OWNER'S NAME
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE
POLICY NUMBER
STREET ADDRESS (Including Apt.. Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER ' COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
Lot_ 18 , Block E EAGLE POINT VILLAGE AT RIVERCHASE -
CITY STATE ZIP CODE
Coppell Texas
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIXd.
GATE OF FIRM INDEX
5. FIRM ZONE
S. BASE FLOOD ELEVATION
(In AO Ione. use depth)
480170
0010
E
Apr. 15, 1994
AE,X (shade
I)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): '_X-NGVD '29 L2 Other (describe on back)
S. 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 I .LJ feet NGVD (or other FIRM datum -see Section B, Item 7).
SECTION C BUILDING ELFWATION 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 1
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 IL ` 144181.191 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 .L I 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 L I .LJ feet above ❑ or
below I_ (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 ! I I 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? f-1 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 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 FIRM: ❑ Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: R1 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: ' 44LOJ .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_—t_! !J .LJ feet NGVD (or other FIRM datum -see Section B, Item 7).
2. Date of the start of construction or substantial improvement
..rrn • -re . I f �Mr%rlrly to cnmry is err. or.vrRCF SIDE FOR CONTINUATION
SECTION E CERTIFICATION
phis 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 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 rprtify flint (tre information in Sections B and C on this certificate represents my best efforts to interpret the dataMZXIWZ�
I understand that any /a/se statement mwy be pirnialfrfble by fine or imprlsonmont under 10 U.B. Cadre, 8ecflen f
CEnIIFIEIT'S NAME LICENSE NUMBER (or Alllx Seel) i�'�\
Glenn W. Miller Geodata Surveying, Inc,. GLENN w. MILLER
TITLE COMPANY NAMESurveyor
.r•
4223 se •
ADDnESS CITY ••«•••v�, IP
P.O. Box 13556 Arlington Tex
SIGNnTUnE �, `n^ DTE 8�� P E
,Yv ct[ 261-2878
Copies should be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner.
COMMENTS: ________ Benchmarks_ used to determine this elevation are taken from engineering
plansused in the construction of the subdivision (Nathan D. Maier Cons.
Engineers) and have not been verified with the FEMA reference mark
elevations.
017 Willi ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A V
20NES 20NES ZONES ZONES ZONES
- REFENENCE
r1FFE'1E1+CE BASE LEVEL
IE VEI FLOOD
REFERENCE
LEVEL
ELEvA110N
�...-.�. t. C
tfiEFEIIENCE
.:.:;
BASE •.
BASE. r NEFERENCE
FLOOD AOJACf NT tri LEVEL
r'NADE
FLOOD
ELEVAitON
ELEVAItON ,
ADJACENT
GNAOF
t
wDJACt NI
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.
i