FEMA-EC160128U.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
Nctional Flod Imrmce Progm
ELEVATION CERTIFICATE
IMFORTANT: Follow the instructions on pages 1-9.
OMB No. 1660-0008
Expiration Date: July 3L,2Ot5
A2. BuildinE
14
SECTION A - PROPERTY INFORMATION
A1. Building Owner'S Name MITCHELL W. WARREN AND KELLI A. WARREN
Suite, andlor Bldg. No.) or PO. Route and Box No.
civ coppeLL State
TX zlP code 7501g
A3'PropertyDeScription(LotandBlockNumberS,TaXParcelt.lum
LOT 6R, BLOCKA, COTTONWOOD ESTATES
44. Building Use (e.9., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENCE
A5. Latitude/Longitude: l-31. 35-5R-24 Long. 97-00-17 Horizontat Datum: n NAD 1927 E NAD1983A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1R
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s)
sqft
the attachedgarageb) Number of permanent flood openings in the crawlspace
or enclosure(s) within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b
d) Engineered flood openings? [ Yes E fVo
A9.
sqft
sqin
For a building with an attached garage:
a) Square footage of attached garage
b) Number of permanent flood openings in
within 1.0 foot above adjacent grade
c) Total net area of flood openings in Ag.b
d) Engineered flood openings? [ Yes
sq tn
ENo
sEcTloN B - FLOOD TNSURANCE RATE MAp (F|RM) INFORMATTON
810. lndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in ltem Bg:
I FIS Profile E FIRM flCommunity Determined D Other/Source:
811. lndicate elevation datum used for BFE in ltem 89: E NGVD 1929 E NAVD 1988 n Other/Source:
812. ls the building located in a Coastal Barier Resources System (CBRS) area or Otherwise protected Area (OpA)?
DesignationDate:_/ _/_ IICBRS tlopA
flYes El No
81. NFIP Community Name &
COPPELL
Number 82. County Name
DALLAS
83. State
TX
84. MaplPanel Number
4B1 1C013s
85. Suffix
J
86. FIRM lndex Date
AUG.23,2001
87. FIRM Panel Effective/
Revised Date
suG.23,2001
88. Flood Zone(s)
AE
Base Flood Elevation(s) (Zone
AO, use base flood depth)
473.0
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1- Buildingelevationsarebasedon: !ConstructionDrawings* !auitcingUnderConstruction* EFinishedConstruction*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A3O, AR/AH, AR/AO. Comptete ttems
C2.a-h below according to the building diag'am specified in ltem A7. ln Puerto Rico only, enter meters-
Benchmark r111117s6. GPS-TRIMBLE RTK NETWORK Vertical Darum: NAVD jgSB
lndicate elevation datum used for the elevations in items a) through h) below fl NGVD 1g2g
Datum used for building elevations must be the same as that used for the BFE.
Dil NAVD 1988 n other/Source;
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the next higher floor
c) Bottom ofthe lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
Describe type of equipment and location in Comments)
0 Lowest adjacent (finished) grade next to buitding (LAG)
g) Highest adjacent (finished) grade next to buitding (HAG)
h) Lowest ad.jacent grade at lowest elevation of deck or stairs, including
structural support
481 .7
480.8
473. 0
480
Check the measurement used.
l feet E meters
feet I meters
I feet I meters
I feet E meters
E feet n meters
fi feet ! meters
E| feet I meters
feet n meers
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
iF s
JAtr'ES'-t- iiilti'ii
kffff&
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to cer1ry elevation
information- I certify thatthe information on this Certificate /'epresents my best efforts to interpret[ne data avaitabte.
I understand that any false statement may be punishable by fine or imprisonment under 78 U,S. Code, Section 1OO1.
n Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
El Check here if attachments. licensed land surveyor? [ yes I trto
Form 086+33 (Revised 7/12)See reverse side for continuation.Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS
See Instructions for ltem 46.
FEMA Form O86-G33 (Revised 7/12)Replaces all previous editions
ELEVATION CERTIFICATE, page 4 BU|LD|NG PHOTOGRAPHS
Continuation Page
IMPORTANT: ln these spaces, copy the corresponding infrormation lrom Section A.FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or pO. Route and Box No.
141 Cottonwood Drive
Policy Number:
City
Coppell
State
Tx
ZIP Code
75019
Company NAIC Number
lf submitting more photographs than will fit on the preceding page, affix the additional photographs below. ldentify all photographs with:
date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must
show the foundation with representative examples of the flood openings orvents, as indlcated in Section A8.
4
ffi ..''
i\ -sq5
1!- \ :\-:- \i..r
l
View facing Northeast from
the West properly corner
View facing the back of the
house from the West
property line.
FEMA Form 086-0-33 (Revised 7/12)Replaces all previous editions.