FEMA-EC160118U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATIO CETIFICA
FEDERAL EMERGENCY MANAGEMENT AGENCY I OMB No. 1660-0008
National Flood Insurance Progront Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015
SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owners Name LOESBERG, LANCED Policy Number:
A2, Building Street Address {including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
136 Trinity Court
City Coppell
State TX ZIP Cbde 75019
A3.
Property
Description {Lot and Block
Numbers, Tax Parcel
Number, Legal Description, etc.)
Lot
11,
B6, FIRM Index Date B7. FIRM Panel
Block
B9. Base Flood Elevation(s) (Zone
48113CO155
A,
Trinity Shores Addition -
TID#180066700A0110000
A4: Building Use (e.g., Residential, Non -Residential, Add tion, Accessory, etc.} Residential
A5. Latitude/Longitude: Lat. 32.96405 Long. -96.94484 Horizontal Datum: ❑ NAD 1927 0 NAD 1983
A6. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood insurance.
AT 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 crawispace or enclosures) n/a sq ft a) Square footage of attached garage Na sq fit
b) Number of permanent flood openings in the crawispace b) Number of permanent flood openings in the attached garage
or enclosure(s) 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.bn/a sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes 0 No
SECTION B —FLOOD INSURANCE RATE MAP
INFORMA'T'ION
61. NFIP Community Name
Coppell - City of
B10. Indicate the source
&.Community Number
B2. County Name
Dallas
83. State
TX
B4. Map/Panel Number
B5: Suffix
B6, FIRM Index Date B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
48113CO155
K
July 7, 2014 Effective/Revised Date
July 71 2014
Zone(s)
n/a
AO, use base flood depth)
442.94
of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69.
❑ FIS Profile In FIRM ❑ Community Determined ❑ Other/Source:
1311. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 IE 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)
Cl, Building elevations are based on: ❑ Construction Drawings* 0 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, ARIA, ARAE, AR/A1 A30, AR/AH, ARIAO, Complete Items C2:a4
below according to the building diagram specified in Item A7. In.Puerto Rico only, enter meters.
Benchmark Utilized: City of Coppell # 4 Vertical Datum: NAV088
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 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, orawlspace, or enclosure floor) 451.21 ®feet El meters
b) Top of the next higher floor nla. feet ❑meters
c) Bottom of the lowest horizontal structural member (V 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 land surveyor, engineer, or architect authorized bylaw to certify elevation
information. I certify that the information on this Ceriiticate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by Arne orimprlsonment under 18 U.S. Code, Section 1009.
❑ Check here if comments are provided on back of form. Were lafitude and longitude in Section A provided by a
❑ Check here if attachments. Licensed land surveyor? ❑ Yes 0 No
Certifier's Name Frederick H. Westphal) .License Number 5832
Title RPLS Company Name Arthur Surveying Company
Address 220 F_Im Street, Ste. 200 City Lewisville State TX ZIP Code 75067
FEMA Form 086-0-35 (7112) See reverse side for continuation. Replaces ail previous editions.
ELEVATION CERTIFICATE, page 2
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.
136 Trinity Court
City Coppeil
State TX ZIP Code 75019
SECTION D --SURVEYOR, ENGINEER, QR ARC}i1TEGT CERTIFICATION {CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments
A7* - Building under construction, proposed diagram 16.
ANY t1SE
SECTIQN E — BUILDING ELEVATIQN INFORMATION {SURVEY NOT RE4UIRED) FOR ZONE AQ AND ZONE A {WITHOUT 13FE)
For Zones AO and A (without BFE), complete Items Ei—E5. If the Certificate is intended to support a LOIVIA or LOMB -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
(elevationC2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ maters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is 4 ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E6, 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
Signature
Comments
City
Date
State ZIP Cade
Telephone
Check here if attachments.
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 Sect(ons A, B, C (or E), and G
of this Elevation Certificate. Complete the applicable item(s) 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 a FEMA -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 Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for. ❑New Construction ❑Substantial improvement
G8. Elevation of as -built lowest floor (including basement) of the building: ❑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
Community Name
Signature
Comments
Title
Telephone
Date
Check here if attachments.
FEMA Form 086-0-33 (7112) Replaces aq previous editions.
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