FEMA-EC081201US DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB N0 1660 0008
Federal Emergency Management Agency Exbires February 28 2009
National Flood Insurance Program Important Read the instructions on pages 1 8
SECTION A PROPERTY INFORMATION Forinsurance Company Use
Al Building Owners Name Polrcy Number
A2 Building Street Address including Apt Unit Suite and or Bldg No or PO Route and Box No Company NAIL Nturiibet
212 Olympia Lane
City State ZIP Code
Co e 1 1 TeXA R
A3 Property Description Lot and Block Numbers Tax Parcel Number Legal Description etc
75n 19
Lot 15 Block A ALEXANDER COURT
A4 Building Use eg Residential Non Residential Addition Accessory etc Resident i al
A5 Latitude Longitude Lat Long Horizontal Datum NAD 1927 NAD 1983
A6 Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance
A7 Building Diagram Number
A8 For a building with a crawl space or enclosures provide A9 For a building with an attached garage provide
a Square footage of crawl space or enclosures sq ft a Square footage of attached garage sq ft
b No of permanent flood openings in the crawl space or 8 No of permanent flood openings in the attached garage
enclosures walls within 10 foot above adjacent grade walls within 10 foot above adjacent grade
c Total net area of flood openings in A8b sq in c Total net area of flood openings in A9b sq in
SECTION B FLOOD INSURANCE RATE MAP FIRM INFORMATION
B1 NFIP Community Name Community Number B2 County Name
Y
83 State
Coppell Tx 480170 Dallas Texas
B4 Map Panel Number 85 Suffix 136 FIRM Index B7 FIRM Panel
IT
88 Flood B9 Base Flood Elevations Zone
Date Effective Revised Date Zones AO use base flood depth
48113C0155 J Aug23 2001 Apr24 2008 AE Xshadel 489
B10 Indicate the source of the Base Flood Elevation BFE data or base flood depth entered in Item B9
FIS Profile Q FIRM LI Community Determined El Other Describe LOMB Case No 07 06 2203P
B11 Indicate elevation datum used Ter BFE in Item 89 NGVD 1929 NAVD 1988 Other Describe
B12 Is the building located in a Coastal Barrier Resources System CBRS area orOtherwise Protected Area OPA Q nYesNI NODesignationDateflCBRSDOPA
SECTION C BUILDING ELEVATION INFORMATION SURVEY REQUIRED
Cl Building elevations are based on Construction Drawings Building Under Construction Finished Construction
A new Elevation Certificate will be required when construction of the building is complete
C2 Elevations Zones A1A30 AE Ali A with BFE VE V1 V30 V with BFE AR AR A ARAE AR A1 A30 AR AH AR AO Complete Items C2a gbelowaccordingtothebuilding diagram specified in Item A7
Benchmark Utilized Ci ty of Goppe11 Mon Vertical Datum
ConversionComments
Check the measurement used
a Top of bottom floor including basement crawl space or enclosure floor 497 J feet LI meters Puerto Rico only
b Top of the next higher floor feet fu meters Puerto Rico onlycBottomofthelowesthorizontalstructuralmemberVZonesonlyL7feetmetersPuertoRicoonlydAttachedgaragetopofslabjJfeetmetersPuertoRicoonly
e Lowest elevation of machinery or equipment servicing the building u feet meters Puerto Rico onlyDescribetypeofequipmentinComments
f Lowest adjacent finished grade LAG feet meters Puerto Rico onlygHighestadjacentfinishedgradeHAGfeet0metersPuertoRicoonly
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 elevationinformationcertifythattheinformationon this Certificate represents my best efforts to irepret the data availableunderstandthatanyfalsestatementmaybepunishablebyfineorimprisonmentunder18USCodeSection1001 0 TSTFr9riyG9sCheckhereifcommentsareprovidedonbackofform
O1
Certifiers Nm License Number GLENN it MILLER
Glenn W Miller State of Texas No 4223 isTitleCompanyName4
RPL 1 0SGeodataSurveyingInc4iESS4 Q
DAddressCityStateZIPCodeti1
15 0 Gina Drive Arlington Texas 76013SignaturDateTelephone12otOS8172612878
FEMA Form 81 31 February 2006 See reverse side for continuation Replaces all previous editions
IMPORTANT In these spaces copy the corresponding information from Section A 111100SdfanCOgoimostiyivozgiligiudiiBuildingStreetAddressincludingAptUnitSuiteandorBldgNoorPORouteandBoxNoPoliryNumber
City State ZIP Code Co NAIL Nflmber
7501CoppellTexas 9
wpahy
l
SECTION D SURVEYOR ENGINEER OR ARCHITECT CERTIFICATION CONTINUED
Copy both sides of this Elevation Certificate for 1 community official 2 insurance agentcompany arid 3 building owner
Comments
BFE Elevations taken from LOMR dated April 24 2008 Case No 07 06 2203P
Signature Date
Check here if attachments
SECTION E BUILDING ELEVATION INFORMATION SURVEY NOT REQUIRED FOR ZONE AO AND ZONE A WITHOUT BFE
For Zones AO and A without WE complete Items E1 E5 If the Certificate is Intended to support a LOMA or LOMRF request complete Sections A BandCForItemsE1E4usenaturalgradeifavailableCheckthemeasurementusedInPuertoRicciwilyentermeters
El Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacentgrade1IAGandthelowest adjacent grade LAG
a Top of bottom floorincluding basement crawl space or enclosure is feet L meters above or below the HAGbTopofbottomfloorincludingbasementcrawlspaceorenclosureisfeetmetersaboveorbelowtheLAG
E2 For Building Diagrams 68 with permanent flood openings provided in Sectior1A Items 8 aridOr 9 see age 8 of Instructions the next higher floorelevationC2binthediagramsofthebuildingisDfeetUmetersaboveorAbelow the I IAGE3Attachedgaragetopofslabisfeetmeters0aboveorbelowtheHAGE4TopofplatformofmachineryandorequipmentservicingthebuildingisfeetCmetersaboveor below the HAG
E5 Zone AO only If no flood depth number is available is the top of the bottom floor elevated in accordance with the communitys floodplain managementordinanceYesNoUnknownThe local official must wilily this information in Section G
SECTION F PROPERTY OWNER OR OWNERS REPRESENTATIVE CERTIFICATION
The property owner or owners authorized representative who cermpletes Sections A B and 5 for Zone A without a FEMA issued or community issued BFEorZoneAO must sign here The statements in Sections t 13 and E am correct to the best of my knowledgeProperlyOwnersOrOwnersAuthorizedRepresentativesName
Address
City State 71h Code
Signature Dale Telephone
Comments
Check here if attachments
SECTION G COMMUNITY INFORMATION OPTIONALThelocal official who is authorized by law or ordinance to administer the communitys floodplain rmanagerierd ordinance can complete Sedions A 9 C or EandGofthisElevationCertificateCompletetheapplicableitemsandsignbelowCheckthemeasurementusedinItemsG8andG9
01 l The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor engineer or architect who
02 Ll is authorized by law to certify elevation information Indicate the source and date of the elevation data in the Comments area below
G3 LiA community official completed Section E for a building located in Zone A without a FEMA issued gr communityissued BFE or 7one AOThefollowinginformationItemsG4G9isprovidedforcommunity floodplain management purposes
LIG Permit Number 105 Date Permit Issued
Date
Cerlificale Of Compliance Occupassued
G7 This permit has been issued for 1 New Construction Substantiivn
tGDe
al I mprovement
08 Elevation of as built lowest floor including basement of the building
zone AO depth of flooding09BFEyrtint at the buildin
0 feet 0 meters PR Dalurtt9qsite1feet0metersP5Datum
Local Officials Name
rifle
Community Name T
felephone
Signature
Dale
Comments
FEMA Form 8131 February 2OOg i T Check here if attachments
Replaces all previous editions
t