FEMA-EC051026FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
a.MS. No. 3067-0077
Expires December 31,2005
ELEVATION CERTIFICATE
SECTION A. PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME
Policy Number
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No) OR P.O. ROUTE AND BOX NO. Company NAIC Number508ROCKEYBRANCHLANE
Important: Read the instructions on pages 1 .7.
CITY STATE
COPPELL TX
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 20 BLOCK '2 NORTH LAKE WOODLANDS
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary)RESIDENTIAL
LATrr'UDElLONGITUDE (OPTIONAL)
11#' -11#' -11#.11#" or 11#.#####')
ZIP CODE
75019
HORIZONTAL DATUM:
NAD 1927 0 NAD 1983
SOURCE 0 GPS (Type).=------------
o USGS Quad Map ~ Other FIRM
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER
COPPELL 480170
B2. COUNTY NAME
DALLAS I B3.STATE
TEXAS OJ
J
I
I
84. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVA TION(S)NUMBER B5 SUFFIX 86. FIRM INDEX DATE EFFECTIVElREVISED DATE B8. FLOOD ZONE(S) (Zone AO, use depth of flooding)48113C0155 J 06-16-D5 08-23-01 X NA
B10. Indicate the source of the Base FlocxJ Elevation (BFE) data or base flocxJ depth entered in B9,
o FIS Profile k3J FIRM 0 Community Determined 0 Other (Describe):_
B11.lndicatethe elevation datum used lor the BFE in B9: k3J NGVD 1929 0 NAVD 1988 0 Othe'(Describe)_
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 '( es k3J No Designation Date
SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: 0 Construction Drawings" k3J Building Under Construction" 0 Finished Construction
A new Elevation Certificate will be required when construction 01 the building is complete.
C2. Building Diagram Number 1 (Select the building diagram most similar to the building lor which this certificate is being comr,leted - see pages 6 and 7 II no diagramaccuratelyrepresentsthebuilding, provide a sketch or photograph.)
C3. Elevations-ZonesA1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARJA, ARJAE, ARJA1-A30, ARJAH, AR/AO
Complete Items C3-a~ below according to the building diagram specified in Item C2. State the datum used. If the datum i; different lrom the datum used for the BFE In
Section B, convert the datum to that used lor the BFE, Show field measurements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G, as appropriate, to document the datum conversion.
Dalum NGVD1929 Conversion/Comments ELEV. 487.17
Elevation reference mark used RM 199 Does the elevation reference mark used appear on the FIRM? k3J Yes k3J No
o a) Top 01 bottom floor (including basement or enclosure) 497,. 80 ft.(m)
o b) Top of next higher floor 499. . 80ft.(m)
o c) Bottom of lowest horizontal structural member (V zones only) NA . _ft.(m)
o d) Attached garage (top of slab) 498. 00 ft.(m)
o e) Lowest elevation of machinery and/or equipment
servicing the building (Describe in a Comments area) NA , _ft.(m)
r.J n Lowest adjacent (finished) grade (LAG) 495. 64 ft.(m)
l.) g) Highest adjacent (finished) grade (HAG) 499. llft(m)
l.) h) No. of permanent openings (flocxJ vents) within 1 ft. above adjacent grade NA
lJ i) Total area of all permanent openings (flocxJ vents) in C3.h !'JA...sq in. (sq. em)
iii
00
0"
E c
w'"
Qi
0 ~
E1ii
c
z.2>
c
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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 elevation information.
I certify that the Information in Sections A, 8, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section to01.
CERTIFIER'S NAME BARRY RHODES LICENSE NUMBER 3691
TITLE OWNER COMPANY NAME BARRY RHODES
CITY
ROWLETT
DATE
10-26-2005
STATE
TX
TELEPHONE
972-475-8940
ZIP CODE
75088
ADDRESS
7509 PENNRIDGE CIRCLE
SIGNAT E
See reverse side for continuation.Replaces all previous editions
IMPORT ANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:BUiLDiNG STREET ADDRESS (Induding Apt, UnIT, Suite, and/or Bklg, No.) OR PO ROUTE AND BOX NO Policy Number508ROCKYBRANCHLANE
CITY STATE ZIP CODE Company NAIC NumberCOPPEllTX75019
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVcompany, and (3) building owner,
COMMENTS
o Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4, If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,Section C must be completed,
E1, Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed _ see pages 6 and 7. If no diagram accuratelyrepresentsthebuilding, provide a sketch or photograph,)
E2, The top of the bottom floor (including basement or enclosure) of the building is _ ft,(m) _in,(cm) 0 above or 0 below Icheck one) the highest adjacent grade, (Usenaturalgrade, if available),
E3. For BUilding Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft,(m) _in,(cm) above the highest adjacentgrade, Complefe items C3.h and C3.i on front of form
E4, The top of the plafform of machinery and/or equipment servicing the building is _ ft,(m) _in,(cm) 0 above or 0 below I,check one) the highest adjacent grade, (Usenaturalgrade, if available),
E5 For Zone AO only If no flood depth number is available, is the top of lhe bottom floor elevated in accordance with the community's floodplain management ordinance?DYes 0 No 0 Unknown, The local official must certify this info'mation in Section G,
SECTION F. PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owners authorized representative who completes Sections A, B, C (Items C3h and C3.i only), and E for Zone A (wilhout a FEMA~ssued or community-issued BFE) or Zone AO must sign here, The statements in Sections A, B, C, and E are correct to the best of my knowledge,
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
o Check here if attachmenls
SECTION G. COMMUNITY INFORMATION (OPTIONAL)
The Iccal official who is authorized by law or ordinance to administer the community's floodplain management ordinance can corrplete Sections A, B, C (or E), and G of this Elevation
Certificate, Complefe the applicable item(s) and sign below,
G 1, 0 The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information, (Indicate the source and date of the elevation data in the Comments area be ow.)
G2, 0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community~ssued BFE) or Zone AO,
G3. 0 The following information (Items G4-G9) is provided for community floodplain management purposes,
G6, DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED J
G4, PERMIT NUMBER G5, DATE PERMIT ISSUED
G7, This permit has been issued for: 0 New Construction 0 Substantial Improvement
G8, Elevation of as-built lowest floor (including basement) of the building is:
G9, BFE or (in Zone AO) depth of flooding at the building site is:
LOCAL OFFICIAL'S NAME
ft,(m)
ft,(m)
Datum:
Datum:
COMMUNITY NAME
SIGNATURE
COMMENTS
TITLE
TELEPHONE
DATE
o Check here if attachments
FEMA Form 81-31, January 2003
Replaces all previous editions