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FEMA-EC140714�pART',y� FEMA NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE AND INSTRUCTIONS ELEVATION CERTIFICATE PAPERWORK REDUCTION ACT NOTICE Public reporting burden for this data collection is estimated to average 3.75 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street SW, Washington DC 20472, Paperwork Reduction Project (1660-0008). NOTE: Do not send your completed form to this address. PURPOSE OF THE ELEVATION CERTIFICATE The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP). It is to be used to provide elevation information necessary to ensure compliance with community floodplain management ordinances, to determine the proper insurance premium rate, and to support a request for a Letter of Map Amendment (LOMA) or Letter of Map Revision based on fill (LOMR-F). The Elevation Certificate is required in order to properly rate Post -FIRM buildings, which are buildings constructed after publication of the Flood Insurance Rate Map (FIRM), located in flood insurance Zones A1 -A30, AE, AH, A (with BFE), VE, Vl-V30, V (with BFE), AR, AR/A, AR/AE, AR/Al-A30, AR/AH, and AR/AO. The Elevation Certificate is not required for Pre -FIRM buildings unless the building is being rated under the optional Post -FIRM flood insurance rules. As part of the agreement for making flood insurance available in a community, the NFIP requires the community to adopt floodplain management regulations that specify minimum requirements for reducing flood losses. One such requirement is for the community to obtain the elevation of the lowest floor (including basement) of all new and substantially improved buildings, and maintain a record of such information. The Elevation Certificate provides a way for a community to document compliance with the community's floodplain management ordinance. Use of this certificate does not provide a waiver of the flood insurance purchas e requirement. Only a LOMA or LOMB F from the Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal mandate for a lending institution to require the purchase of flood insurance. However, the lending institution has the option of requiring flood insurance even if a LOMA/LOMR-F has been issued by FEMA. The Elevation Certificate may be used to support a LOMA or LOMR F request. Lowest floor and lowest adjacent grade elevations certified by a surveyor or engineer will be required if the certificate is used to support a LOMA or LOMR-F request. A LOMA or LOMR-F request must be submitted with either a completed FEMA MT -EZ or MT -1 package, whichever is appropriate. This certificate is used only to certify building elevations. A separate cert ificate is required for floodproofing. Under the NFIP, non-residential buildings can be floodproofed up to or above the Base Flood Elevation (BFE). A floodproofed building is a building that has been designed and constructed to be watertight (substantially impermeable to floodwaters) below the BFE. Floodproofing of residential buildings is not permitted under the NFIP unless FEMA has granted the community an exception for residential floodproofed basements. The community must adopt standards for design and construction of floodproofed I basements before FEMA will grant a basement exception. For both floodproofed non- residential buildings and residential floodproofed basements in communities that have been granted an exception by FEMA, a floodproofing certificate is required. Additional guidance can be found in FEMA Publication 4674, Floodplain Management Bulletin: Elevation Cert ificate, available on FEMA's website at http://www.fema.gov/library/viewRecord.do?id=1727. U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 Nationa/FloodlnsuranceProg�•am Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A -PROPERTY INFORMATION Building Owner's Name A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg 732 Da Vinci Court I:t.11[i�Ti[:�id7►L.7 City Coppell State TX LIN Code i5D1y A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 20 of Willow Park -Tax Parcel No. 18006990000200000 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 32.98515 Long. 97.01295 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 1 B A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosures) n/a sq ft a) Square footage of attached garage 335+- sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosures) within 1.0 foot above adjacent grade n/a within 1.0 foot above adjacent grade n/a c) Total net area of flood openings in A8.b n/a sq in c) Total net area of flood openings in A9.b n/a sq in d) Engineered flood openings? ❑Yes ®No d) Engineered flood openings? ❑Yes ®No SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name &Community Number B2. County Name B3. State Coppell - 480170 Dallas TX B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevations) (Zone 4811300135 L 7-7-14 Effective/Revised Date Zones) AO, use base flood depth) 7-7-14 n/a n/a B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ❑FIRM ❑Community Determined ❑Other/Source: B11. Indicate elevation datum used for BFE in Item 69: ❑NGVD 1929 ❑NAVD 1988 ❑Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑Yes ®No Designation Date: ❑CBRS ❑ OPA SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. 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 Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Coppell #2 Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑NGVD 1929 ❑NAVD 1988 ❑ OthedSource: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 480.97 ®feet ❑meters b) Top of the next higher floor 490.97+/- ®feet ❑meters c) Bottom of the lowest horizontal structural member N Zones only) n/a. ❑feet ❑meters d) Attached garage (top of slab) 480.62 ®feet ❑meters e) Lowest elevation of machinery or equipment servicing the building 480.31 ®feet ❑meters (Describe type of equipment and location in Comments) , f) Lowest adjacent (finished) grade next to building (LAG) 478.19 ®feet ❑meters g) Highest adjacent (finished) grade next to building (HAG) 479.95 ®feet ❑meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support n/a. ❑feet ❑meters 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 on this Certificate represents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine or imprisonment under 18 U. S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? ❑Yes ®No Certifier's Name Douglas L. Arthur Title RPLS Address 220 Elm Street, St. 200 Sign ure EMA Form 0-33 (7/12) License Number 4357 Company Name Arthur Surveying Company Lewisville State TX ZIP Code 75067 Date 7/14/2014 Telephone 972-221-9439 See reverse side for continuation. �y 'Q�" � co ��cD� ..i.. DOUGLAS�L.�KRTHUR �. .. /o „.4357 .. �. � ., `'9 ��'9�FESS o�P O� �ti0 SUR��� Replaces all previous editions. FLIEVATi ION OFRTIFICAATF 0� IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 732 Da Vinci Court City Coppell SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments C2E - AC Pad SECTION E For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2, For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is 4 ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ 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 community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section 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 community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, 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 SECTION G —COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) Check here if attachments. and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without aFEMA-issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6, Date Cert ificate Of Compliance/Occupancy Issued G7. This permit has been issued for: E] New Construction El Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: El feet ❑meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Signature Comments Telephone Date Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No, Policy Number: 732 Da Vinci Court City Coppell State TX ZIP Code 75019 Company NAIC Number: If using the Elevation Certificate tVU a" NFIP flood insurance, affix at least 2 building photographs below according tUL e instructions for Item A6. Identify 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 or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. FRONT VIEW REAR VIEW FEMA Form 086-0-33 (7/12) Replaces all previous editions.