FEMA-EC140729U.T. DEPART MENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flaod Ltsurance Program
A1. Building Owner's Name
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-9.
SECTION A -PROPERTY INFORMATION
OMB No. 1660-0008
Expiration Date: July 31, 2015
FOR INSURANCE COMPANY USE
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number: I
709 INGLENOOK COURT
City COPPELL State TX ZIP Code 75019
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 15 OF BLOCK 1 OF ST. ANDREWS ESTATES, AN ADDITION TO THE CITY OF COPPELL, DALLAS COUNTY, TX
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENT
A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑ NAD 1927 ®NAD 1983
A8. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1A
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 N/A 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 62. County Name B3. State
DALLAS CO., &INCORPORATED AREAS 480170 DALLAS TEXAS
B4. Map/Panel Number B5. Suffix 66. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevations) (Zone
4811300155 K 07/07/2014 Effective/Revised Date Zones) AO, use base flood depth)
07/07/2014 X -OTHER 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 B9: ❑NGVD 1929 ®NAND 1988 ®Other/Source: N/A
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: DEFOREST COURT 456.23'
_ Vertical Datum: NAND 1988
Indicate elevation datum used for the elevations in items a) through h) below. ❑NGVD 1929 ®NAND 1988 ❑Other/Source:
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) 455.70 ®feet ❑meters
b) Top of the next higher floor N/A. ❑feet ❑meters
c) Bottom of the lowest horizontal structural member N Zones only) N/A. ❑feet ❑meters
d) Attached garage (top of slab) N/A._ ❑feet ❑meters
e) Lowest elevation of machinery or equipment servicing the building N/A._ ❑feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) N/A._ ❑feet ❑meters
g) Highest adjacent (finished) grade next to building (HAG) N/A._ ❑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. 1 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 BRIAN RHODES License Number 5962
Title OWNER, RPLS Company Name RHODES SURVEYING •`���
Address 4424 STATE HIGHWAY 276 City ROCKWALL State TX ZIP Code 75032 ��d
Signature Date 07/29/2014 Telephone 972-475-8940
FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions.
cLEVA TION 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:
709 INGLENOCK COURT
City COPPELL State TX ZIP Code 75019 Company NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the 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.
90479
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVA'i ION CERTIFICATE, page 4 Building Photographs
Continuation Page
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:
709 INGLENOOK COURT
City COPPELL State TX ZIP Code 75019 Company NAIC Number:
If submitting more photographs than will W the preceding page, affix the additional photographs below. 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.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.