FEMA-EC960909Sep -09-96 01:01P
P.O1
CHICAGO TITLE INSURANCE. COMPANY
598 DENTON TAP ROAR. SIAH 106, COPPEI l., TFXAS 75019 (114} 462.7420 FAX (2141393-5926 W)
ti,060�
Date: ` r
To:
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Company Name:
Fax Number: c ( 7C.
From:t-t�:
Chicago Title Insurance Company - Coppell
Fax number: 393-5926 or 393-9043 - Telephone number: 462-7420
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Total number of pages including cover letter: J
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The information contained in this facsimile message and documents accompanying same are
legally privileged and confidential information intended only for use by the individual or entity
named herein. If the reader of this message is not the intended recipient, you are hereby
notified that any dissemination, distribution or copy of this telecopy is strictly prohibited If
you have received this telecopy in error, please notify us immediately by telephone and return
the original message to us at the address above via the United States Postal Services.
Tliank you.
Sep -09-96 01:01P
P_02
0-M 9, NO. 3067-0077
ELEVATION CERTIFICATE Expires May 31,1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provido 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
BUILDING OWNERS NAME
r•Ul t INSunANCF COMPANY USE
POLIGY Nt1MnrR
STREET ADDFIES:> (IncluU... p Apt. Unit, Suite and/or Bldg- N(imber) OR r?O. ROUTE AND BOX NlJMUI N COMPANY NAIC Nl1MnrR
OTHER UFS041P f ION (Lot and Block Numbers. Pic.)
64c.k r, , Lrtc t`- V,Ct,. k1d; Fi8vk,.
CITY STATE- ZIP CODF
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions).
1 COMMUNITY NUMBER
Z. PANEL NUM19tn
3. 511rMX
s DATE OF FIRM INULX
S. rIRM 7pNE
b. tlASt FLLWD LLEWATION
4,!3 017 U
00/0
A pr;1 15,15) 9 y
(in AO Zones, use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): I",rNGVD -29 I .10ther (describe on back)
a. For Zones A or V. where no BFE is provided on the FIRM, and the community has ostablished a BFE for this building site, indicate
the community's SFE:'L_L_�!J .I— feet NGVD (or other FIRM datum -see Section B, Itern 7),
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrarns found on Pages 5 and 6 that best
describes the subject building's reference level -. / .
2(a). FIRM Zones At -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of LyAiAL3J .1131 feet NGVD (or other FIRM datum --see Section 0, 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 l I I I LL_ feet NGVD (or other FIRM datum -see Section 8, Iters 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from tho selected diagram is I .I feet above [.� or
below 17 (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_L --- : J i feet above' or below J (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? I Yes [__l No L. Unknown
3. Indicate the elevation datum system used in determining the above reference lavol elevations: NGVD '29 I Other (doscribe
under Commonts on Page 2). (NOTE: 11 the elevation datum used in mRasuring the elevations is different than that used on
the FIRM (sen Soction B, Item 71, then convert the elevations to the datum system used on the FIRM arid show the conversion
equation under Comments on Rade 2.)
4. Elevation reference mark used appears on FIRM: I Yes I No (Soo Instructions on Page 4)
5. The reference level elevation is based on: I.v1"aetual construction F 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 Certificsty
will be required once construction is complete.)
6, The elevation of the lowest grade immediately adjacent to the, building is: LJ . 1g1el21.1 S feet NGVD (or other FIRM datum -Soo
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
t. 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: L_ 1 1 , L_I.L _j feet NGVD (or other FIRM datum -see Section B, Item 7).
2. Date of the start of conStrUCtiorl or substantial improvement
FEMA Form 81-31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
Sep -09-96 01:02P
SECTION E CERTIFICATION
P.03
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 (wlthout 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 uso, 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 r'nterprat tho data available.
I understand that any false slatement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
8eA D, Kyc kli k R.P.G 5. No. /430
CERTIFIER•$ NAME LICENSE NUMBER (or Affix SPM)
TITLE COMPANY NAME.
—_104 & 5 ►�'
• 5r -C. !e� 'LLr• DkI(,. S. T
-X 75Ze.)3
ADDRESS CITY STATE ZIP
SIGN AE UAIL PHONE
Copies should be made of this Certificate for., 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS: .../PZL.tim�),N� r d-/oo�/CJaf-rt✓� �2e�r.l�Gc� =!S `>iF37 5�
ON WITH ON PILES,
SLAB BASEMENt PIERS, OR COLUMNS
A V A A V
ZONES ZONES ZONES ZONES TZONES
nFFr ll W.t.
ItV LNCNGL BASE LEVEL LEVEL ROO LEVATHONNFLOOD AWALENT •S,RF.FEAMF nlVA11QN uUIt4NCl AIUAGENtf.IiADF ;? LEVEL
IFVFI (1RAr)F
!,' AO,IACErfT:-
rrf11 lrnl onAnF '.
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
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