FEMA-EC010328COPPELL BUILDING PERMIT APPLICATION Qom,
Print or Type in a Clear, Legible Manner e
Job Address:s f{ Z tt/ Date: 13/d
rQ- ar
Lot: 3 Block: 16 Subdivision: f ra-. -Ford yj c2 d r Phase or Section Number:
Owner: � vd✓t fS E2 � Y,'S�S Gr L� Address: / !- %3 0x— /cf26f Lrf/�i y One
Contractor:,i "507 f— Address: C,.L d
Description of Work to be Done Class of Work: New ❑ Addition LJ Alteration ❑ Repair ❑ Demolition
%�'Q.Gt� ' 9eS' %tet �,`2 i��`�/ Si n � / P rn. •2�L t_{7�j
6
Area of Building in Square Feet
lL
First Floor .3 , 7 � Garage 7 `5 � Value of Work
to be Performed
Second Floor Other.
'b GRAY AREA FOR OFFICE USE ONLY
HOLD HARMLESS AGREEMENT
WHEREAS, THE OWNER OF LOT S , BLOCK, OF THE
e p_ /�'l,e� SUBDIVISION, ( EJ
(ADDRESS), COPPELL, TEXAS (THE OWNER) UNDERSTAND AND ACKNOWLEDGE THAT
THE�WHICH IS LOCATED ON THEIR PROPERTY ENCROACHES ONTO THE
CITY ()F COPPELL '� �.i` '; AND
WHEREAS, THE OWNERS UNDERSTAND AND ACKNOWLEDGE THAT IN CASE
REPAIRS OR IMPROVEMENTS ARE REQUIRED TO BE MADE TO THE CITY OF COPPELL'S
() 1-1 L. t -V EASEMENT WHICH WOULD REQUIRE REMOVAL OF THE DRIVEWAY IN
ORDER TO EFFECT SUCH IMPROVEMENTS; AND
WHEREAS, THE OWNERS RECOGNIZE AND ACKNOWLEDGE THAT SUCH DRIVEWAY
WAS INSTALLED DESPITE KNOWLEDGE OF THE CITY'S Ln)Cr-7 EASEMENT;
OWNERS HEREBY AGREE TO REMOVE SUCH DRIVEWAY AT THEIR OWN COST AND
UPON REQUEST BY THE CITY OF COPPELL, AND IF OWNERS FAIL TO REMOVE THE
DRIVEWAY UPON REQUEST BY THE CITY, THEN CITY WILL REMOVE SUCH DRIVEWAY
AND OWNERS HEREBY INDEMNIFY AND HOLD THE CITY HARMLESS FROM ALL
CLAIMS OF DAMAGE TO THE DRIVEWAY WHICH ARISE FROM THE CITY'S REMOVAL
OF SUCH DRIVEWAY WHILE REPAIRING, INSPECTING, IMPROVING OR IN ANY WAY
SEEKING ACCESS TO THE. VV L11y EASEMENT. ADDITIONALLY, OWNERS AGREE TO
REIMBURSE THE CITY FOR REASONABLE COSTS INCURRED IN REMOVING THE
DRIVEWAY.
All owners of record:
Date �*O� `
(Owner's signature)
(Owner's printed name)
Date
(Owner's signature)
(Owner's printed name)
NOTE. If additional owners are involved, please attach separate sheet for signatures.
HOHARM 14 (driveway/drainage)
Original: City Secretary
Copy: Building Inspections
FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002
ELEVATION CERTIFICATE
Important: Read the instructions on pages I.7.
SECTION A- PROPERTY OWNER INFORMATION05-rd ai e HOME sp 5°° 7777 1
I1/:1►rg
BUILDING STREET ADDRESS (Indudirg Apt, Unit, Suite, ardor Bldg. No.) OR P.O. ROUTE AND BOX NO.
616 Stiatord Lane
CITY STATE ZIP CODE
Copped TX 75019
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lct3, Block Stratford Manor Addition
BUILDING USE (e,g., Residential, Non-residential, Addition, Accessory, & Use Comments section I necessary.)
Residential
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type). -
(
Type):( #ft° # #fk,## or ❑ NAD 1927 ❑ NAD 1983 O USGS Quad Map 0 Ober: City Benchmark
SECTION B - FLOOD INSURANCE RATE MAP (FIRM INFORMATION
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX DATE
B7. FIRM PANEL
B8. FLOOD ZONE(S)
B9. BASE FLOOD ELEVATION(S)
NUMBER
_. _ft.(m)
EFFECTIVEIREVISEDDATE
AM
(Zone AO, use depth offloo ing)
o e) Lowest elevation of machinery and/or equipment
w `°
servicing the building
454.5
131 U. Indicate the source of the lease Flood klevation (8FE) data or base flood depth entered in B9.
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe): _
B11. Indicate the elevation datum used for the BFE in 139: ❑ NGVD 1929 ❑ NAVD 1988 C. Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building UnderConstnrcton' ® Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number_ (Select the building diagram most similarto the building for which this certificate is !hang completed - see pages 6 and 7. t no diagram accurately
represents the building, provide a sketch or photograph.)
C3. f levations – Zones Al -A30, AE, AH, A (with BFE), VE, V1 430, V (with BFE), AIRARIA, ARIAE, ARIA1-A30, AR/AH, AR/AO
Complete ftems C3a- below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in
Section B, convert the datum to that used for 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.
Datum _ Conversion/Comments _
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ❑ No
o a) Top of bottom floor (including basement or enclosure)
469.8 ft.(m)
o b) Top of next higher floor
_ —ft(m)
o
o c) Bottom of lowest horizontal structural member (V zones only)
_. _ft.(m)
o d) Attached garage (top of slab)
AM
on
o e) Lowest elevation of machinery and/or equipment
w `°
servicing the building
o f) Lowest adjacent grade (LAG)
Oft.(m)
z
o g) Highest adjacent grade (HAG)
_.
: ft M
r_
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0
o i) Total area of all permanent openings (flood vents) in C31h 0 sq. in. (sq. cm)
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 orimprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME Joel Wdhile LICENSE NUMBER 5190
TITLE Registered Professional Land Surveyor COMPANY NAME Roome Surveying, Inc.
ADDRESS CITY STATE ZIP CODE
2ani pian, Tu 7Fme
SIGNATURE DATE TELEPHONE
o79-VUz79
FEMA Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
IMPORTANT: In these spaces, copy the corresponding information from Section A
BUILDING STREET ADDRESS (Inducting Apt, Unit Suite, andforBklg. No.) OR P.O. ROUTE AND BOX NO.
610 Stratford Lane
CITY STATE ZIP CODE
CoI)W TX 75019
SECTION D - SURVEYOR, ENGINEER, ORARCHITECT CERTIFICATION (CONTINUED)
Copy moth sides of this Elevation Certificate for (1) community official, (2) insurance agentloompany, and (3) building owner.
COMMENTS
This oerfifmb b for top of fume only and is not to be used for flood imuranoe purposes.
❑ 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 orLOMR-F,
Section C must be completed.
E1. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is bang completed — see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (deck one) the highest adjacent grade.
E3. For Building Diagrams 6-8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) _in.(ctn) above the highest adjacent
grade.
E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance?
❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Semon G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or canmunityAssued BFE) or Zone AO must
sign here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑ Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The"o#flciel who is authorized bylaw or ordinance to administerthe community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation
Certificate. Complete the applicable item(s) and sign below.
G1. ❑ 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" law to certify elevation information. (Indicate the source and dated the elevation data in the Comments area below,)
G2. ❑ A community official completed Section E for a building lasted in Zone A (without a FEMA4ssued or community4ssued BFE) or Zone AO.
G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes.
G6. DATE CERTIFICATE OF
G7. This permit has been issued for, LJ New Construction U Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building is: _ft.(m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
❑ Check here if attachments
FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS
PROPERTY DESCRIPTION
Address: 610'Stratford Lane Lot 3 Block B of Stratford Manor, an addition to the City of Coppell, Dallas County, Texas, according to the plat
thereof recorded in'Volume 2000034, Page 147 of the Map Records of Dallas County, Texas.
E S
88
NOTE: 30' B.L isn't shown, but c
is annotated on the plat.
ad LOT 4
elecom I 1/2�ref.IRF
Riser 1 SIF $$9'38'16' E 159.60' at 159.04' encroaches 0.05
'
W io Variable Width Utility Esm't. :r
O in GTEHH Box N n Vol. 958, Pg. 897 ,a " Adys. wood fence
(as shown on plat)
N M •^_ ' OKencroaches 0.4
OK 2.4 21.6 ,0 37.5
O C\1 N 0.05 I ri 29.00' ' encroaches 0.4
1 Z m ci 20.30Adj e. chats
�
¢U
-1.25 I link fence
3.2-16-35— 1.8
30.4 2 0 a I OT 3 07
I
W O)OD 5 4 MIn.F..F.-- 54.5'
04 p0 2.0 22.85 37.5
ad
a
21.4 0.35 Fortes Only ct
II T.O.F.=469.80'
0 2.8
2.8
O¢` o.a
ILL o � 7.8 I N �
i ^ 3
06 1.5 0.6 t 1.65 o
O O W1 I to N
LQ�
2
O 49.05 20 N I
2�4
IQt, U 12.0 42.75
I
I
rock m OK 0.35 1/2'IRF .on line
OK 0.4esmusso
mailbox OK 0.2
1/i IRF N89'38' 16 W rock ret. wail 168.52'
LOT 2 AdJ's. wood fence
NOTES: (1) Source bearing is based on recorded plat unless otherwise noted. (2) Drainage arrows, if shown, were determined by elevations shown
hereon. (3) (CM) = Controlling monument. (4) Surveyor's seal will appear with red ink on certified copies. (5) Subject property is affected by any and
all notes, details, and easements, and other matters, that are shown on or as part of the recorded plat and/or as part of a title commitment/survey
request.
CERTIFICATION
On the basis of my knowledge, information and belief, I certify to WVndSOr Homes that as a result of a survey made on the ground to the normal
standard of care of Registered Professional Land Surveyors practicing in the State of Texas, I find the plat hereon is true, correct, and accurate as to
the boundaries of the subject property, and if shown, location and type of buildings and visible improvements hereon.
Scale: V=30' Date: 3/27/2001 Revised: Job No. 010165
Title commitment/Survey Request Fife No. dated
ROOME SURVEYING, INC.
••2000
AVENUE G
JOELtL.
.., A
SUITE 804
5190
X90:
PLANO, TX 75074
5URVO�
Phone Number (972) 423-4372 Fax Number: (972) 423-7523
R