St Andrews Est-CS050228I [HENNESSEY ENGINEERING, INC.
~ 1417 W. MAIN ST. - SUITE 100 - CARROLLTON, TEXAS 75006-6912
,,) (972) 245-9478 - FAX (9!2) 245-7~087
[] TRANSMITTAL [] TELEPHONEf-/ [] MEETING [] OBSERVATION
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COPPELL
FEDERAL EMERGENCY MANAGEMENT AGENCY I O.M.B. NO. 3067-0147
COMMUNITY ACKNOWLEDGMENT FORM Expires September 30, 2005
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this form is estimated to average 0.88 hour per response. The burden estimate includes the time for reviewing instructions,
searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form. You are not required
to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Send comments regarding
the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Federal Emergency
Management Agency, 500 C Street, SW, Washington DC 20472, Paperwork Reduction Project (3067-0147). Submission of the form is required to
obtain or retain benefits under the National Flood Insurance Program. Please do not send your completed survey to the above address.
This form must be completed for requests involving the existing or proposed placement of fill (complete Section A) OR to provide acknowledgment of
this request to remove a property from the SFHA which was previously located within the regulatory floodway (complete Section B).
This form must be completed and signed by the official responsible for floodplain management in the community. The community number and the
subject property address must appear in the spaces provided below.
Community Number: 480170 Property Name or Address: St Andrews Estates, Coppell, TX (six lots)
A. REQUESTS INVOLVING THE PLACEMENT OF FILL
As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this Letter of Map Revision
Based on Fil[ (LOMR-F) or Conditional LOMR-F request. Based upon the community's review, we find the completed or proposed project meets or is
designed to meet all of the community floodplain management requirements, including the requirement that no fill be placed in the regulatory floodway,
and that all necessary Federal, State, and local permits have been, or in the case of a Conditional LOMR-F, will be obtained. In addition, we have
determined that the land and any existing or proposed structures to be removed from the SFHA are or will be reasonably safe from flooding as defined in
44CFR 65.2(c), and that we have available upon request by FEMA, all analyses and documentation used to make this determination. For LOMR-F
requests, we understand that this request is being fonvarded to FEMA for a possible map revision.
Community Comments: Request is for six lots: Lot Nos. 5, 6,7, 8, 16 and 17, addressed as 620, 624, 628, 632, 703 and 629 Inglenook Court.
Community Official's Name and Title: (Please Pdnt or Type} Telephone No.:
Kenneth M. Gdffin, P.E., Director of En~lineerin~l and Public Works /9721 304-3686
Community Name: Community Official's Signature: (required) Date:
City of Coppell ,,~,4¥~, ~,~./.- ~.., ~,,~., ,,~.
B. PROPERTY LOCATED WITHIN THE REGULATORY FLOODWAY
As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this request for a LOMA.
We understand that this request is being forwarded to FEMA to determine if this property has been inadvertently included in the regulatory floodway.
We acknowledge that no fill on this property has been or will be placed within the designated regulatory floodway. We find that the completed or
proposed project meets or is designed to meet all of the community floodplain management requirements.
Community Comments:
Community Officiars Name and Title: (Please Print or Type) Telephone No.:
Community Name: Community Official's Signature (required): Date:
FEMA Form 81-87B, SEP 02 Community Acknowledgment Form MT-I Form 3 Page I of I
FEDERAL EMERGENCY MANAGEMENT AGENCY
PROPERTY INFORMATION FORM
I O.~B. NO. 3067-0147
Expires S~ptember 30, 2005
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this form is estimated to average 1.63 hours per response. The burden estimate includes the time for reviewing instructions
searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form. You are not required
to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Send comments regarding
the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Coliestions Management, Federal Emergency
Management Agency, 500 C Street, SW, Washington DC 20472, Paperwork Reduction Project (3067-0147). Submission of the form is required to obtain
or retain benefits under the National Flood Insurance Program. Please do not send your completed survey to the above address.
This form may be completed by the property owner, property owner's agent, licensed land surveyor, or registered professional engineer to support a
request for a Letter of Map Amendment (LOMA), Conditional Letter of Map Amendment (CLOMA), Letter of Map Revision Based on Fill (LOMR-F), or
Conditional Letter of Map Revision Based on Fill (CLOMR-F) for existing or proposed, single or multiple lots/structures. Please check the item below
that describes }/our rec~uest:
] LOMA A letter from FEMA stating that an existing structure or parcel of land that has not been elevated by fill
(natural grade) would not be inundated by the base flood.
[] CLOMA A letter from FEMA stating that a proposed structure that is not to be elevated by fill (natural grade)
would not be inundated by the base flood if built as proposed.
] A letter from FEMA stating that an existing structure or parcel of land that has been elevated by fill
LOMR-F
would not be inundated by the base flood.
A letter from FEMA stating that a parcel of land or proposed structure that will be elevated by fill
] CLOMR-F would not be inundated by the base flood if fill is placed on the parcer as proposed or the structure is
built as proposed.
Fil~l is defined as material from any source placed to raise the ground to or above the Base Flood Elevation (BFE). The common construction practice of
removing unsuitable existing material (topsoil) and backfilling with select structural material is not considered the placement of fill if the practice does not
alter the existing (natural grade) elevation, which is at or above the BFE. Fill that is placed before the date of the first National Flood Insurance
Program (NFIP) map showing the area in a Special Flood Hazard Area (SFHA) is considered natural grade.
Has fill been placed on your property? [] Yes [] No If yes, when was fill placed? Nov12004
month/year
Will fil~ be placed on your property? [] Yes [] No if yes, when will fill be placed? /
month/year
I Street Address of the Property (if request is for multiple structures, please attach additional sheet):
620, 624, 628, 632, 703, 629 Inglenook Court, Coppeli, Texas 75019.
2. Legal description of Property (Lot, Block, Subdivision) (if a street address cannot be provided):
Lots 5,6,7,8.16,17 - Block A - St. Andrews Estates, City of Coppell, as recorded in Volume 2004-150~ Page 00078, Dallas County Deed Records.
3. Are you requesting that the SFHA designation be removed from (check one):
] the entire legally recorded property?
] a portion of land within the bounds of the property (a certified metes and bounds description and map of the area to be removed,
certified by a licensed land surveyor or registered professional engineer, are required)?
] structures on the property? What are the dates of construction?
4. iS this request for a (check one):
] single structure
] single lot
] multiple structures (How many structures are involved in your request? List the number: )
] multip[e lois (How many lots are involved in your request? List the number: 6)
FEMA Form 81-87, SEP 02 Property Information Form MT-1 Form 1 Page Iot 2
In addition to this form (MT-1 Form t), ALL requests must include the following:
Copy of the Plat Map for the property (with recordation data and stamp of the Recorder's Office)
OR
Copy of the property Deed (with recordat on data and stamp of the Recorder's Off.me), accompanied by a tax assessor's map or other certified
map showing the surveyed Iccation of the property relative to local streets and watercoumes
Copy of the effective FIRM panel and/or Flood Boundary and Floodway Map (FBFM) (if applicable) on which the property location has been
accurately plotted (property inadvertently located in the NFIP regulatory floodway wilJ require Section B of MT-I Form 3)
Form 2- Elevation Form. If an Elevation Certif'mste has already been complsted for this property, it may be submitted in addition to Form 2.
Please include a map scale and North arrow on all maps submitted.
Fo~ LOMR-Fs and CLOMR-Fs, the following must be submitted in addition to the items listed above:
Form 3- Community Acknowledgment Form
proces~no Fee (see instructions for appropriate mailing address; or, visit http:llwww.ferna,gov/fhrnlfrm_fees.shtm for the most current fee schedule)
Revised fee schedules are published periodically, but no more than once annually, as noted in the Federal Reoister. Please note: single/multiple
Iot(s)/structure(s) LOMAs are fee exempt. The current review and processing fees are listed below:
Check the fee that applies to your request:
r~] $325 (single lot/structure LOMR-F following a CLOMR-F)
[] $425 (single lot/structure LOMR-F)
[] $500 (single lot/structure CLOMA or CLOMR-F)
]$700 (multiple lot/structure LOMR-F following a CLOMR-F, or multiple ict/structure CLOMA)
[] $800 (multiple lot/structure LOMR-F or CLOMR-F)
Please submit the Payment Information Form for remittance of applicable fees. Please make your check or money order payable to: National Flood
Insurance Prooram
All documents submitted in support of this request are correct to the best of my knowledge. I understand that any tsise statement may be punishable by
fine or impoSOnment under Title 18 of the United States Code, Section 1001.
Applicant's Name: Peter F. Hennessey, PE.
Please Print or Type
Company: Hennessey Engineering, Inc.
Malting Address: 1417 W. Main Street, Suite 100
Carrollton, Texas 75006
Daytime Telephone No.: (972) 245-9478
E-Mail Address: heneng2{~aol.com
(ol~ional)
-0,.5-
Date
Fax No.: (972) 245-7087
Signature of Applicant (required)
If you have any questions concerning FEMA policy, or the NFIP in general, please contact the FEMA Map Assistance Center toll free at 1-877-FEMA
MAP (1-877-336-2627), or visit the Flood Hazard Mapping wel:~,ite at www.fema.gov/fhm/.
FEMA Fo*mt 81.87, SEP 02 Property Information Fonw MT-1 Form 1 Page 2 of 2
FEDERAL EMERGENCY MANAGEMENT AGENCY
ELEVATION FORM
IO.~a'. B. NO. $0~7-0147
I~e~ $~F~nber 30, 2005
PAPERINORK BURDEN DISCLOSURE NOTICE
Pub{ic reporting burden for this form is estimated to average 1 hour per respense. The burden estimate includes the time for reviewing insbuctions,
searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form. You are not required
to respond to this collection of information unless a valid OMB control number appears in the upper right comer of this form. Send comments regarding
the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Federal Emergency
Management Agency, 500 C Street, SW, Washington DC 20472, Paperwork Reduction Project (3067-0147). SubmiSSion of the form is required to
obtain or retain benefits under the National Flood Insurance Pro, ram. Please do nM send ~our coo~sted survey, to the above address.
This form must be completed for requests and must be completed and signed by a registered professional engineer or licensed land surveyor. A FEMA
National Flood Insurance Program (NFIP) Elevation Certificate may be submitted in addition to this form for single structure requests.
For requests to remove a structure off natural grade OR on engineered fill from the Special Flood Hazard Area (SFHA), submi~ the lowest adjacent
grade (the lowest ground touching the structure), including an attached deck or garage. For requests to remove an entire parcel of land from the SFHA
provide the lowest lot elevation; or, if the request involves an area described by metes and bounds, provide the lowest elevation within the metes and
bounds description.
1. NFIP Community Numbe~: 480170 Property Name or Address: St. Andrews Estates, Coppell, TX
2. Are the elevations listed below based on [] existinq or [] proposed conditions? (Check one)
3. VVhst is the elevation datum? NGVD 29 If any of the elevabons listed below were computed using a datum different than the datum used for the
effective Flood Insurance Rate Map (FIRM) (e.g., NGVD 29 or NArD 88), what was the conversion factor?
Local Elevation +1- ft. = FIRM Datum
4. For the existing or proposed structures listed below, what are the types of construction? (check all that apply)
[] crawl space [] slab on grade [] basementJenclosure [] uther (exptain)
5. Has FEMA identified this area as subject to land subsidence or uplift? (see instructions) [] Yes [] NO
If yes, what is the date of the current releveling? / (month/year)
Lowest
Block Lowest Lot Adjacent Base Flood
Lot Number Number Elevation Grade To Elevation For FEMA Use Only
Structure
5 A 455.3 456.06 453.59
6 A 454.9 456.29 453.59
7 A 454.5 455.64 453.59
This certit-~,atien is to be signed and sealed by a licensed land surveyor, registered professional engiaeer, or amhitect authorized by law to certify
elevation information. All documents sutsnitted in support of this request are correct to the best of my knowledge. I understand that any false
s~atemeht may be punishable by fine or imprisonment under T~e 18 of the United States Code, Section 1001.
Certifier's Name: Peter F. Henneseey, P.E License No ~ 33295 Expiration Date: 12/31105
Company Name: Hennessey Engineering, Inc. Telephone No.: (972) 245-9478 Fax No.: (972) 246-7087
........
FEMA Form 81-87A, SEP 02 Elevation Form MT-1 Form 2 Page 1 of 2
Continued h'om Page 1.
Lowest
Lot Number Block Lowest Lot Adjacent Grade Base Flood
Number Elevation Elevation For FEMA Use Only
To Structure
8 A 454.5 455.48 453.59
16 A 445.0 455.53 453.59
17 A 445.0 45546 453.59
This c~tification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify
elevation information. All documents submitted in support of this request are correct to the best of my Imowledge~ I understand that any false
statement ma~' be punishable by fine or imprisonment under T~e 18 of the United States Code, Section 1001.
Certifier's Name: Peter F. Hennessey, RPLS License No.: 3740 Expiration Date: 12/31/05
Company Name: Hennessey Engineering, Inc. Telephone No: (972) 245-9478 Fax No.: (972) 245-7087
Signature:
~ ,,~ ,P.,E~.,ER HENNESSEY ~
Seal (optional)
FEMA Form 91-87A, SEP 02 Elevation Form MT-1 Form 2 Page 2 of 2
FEDERAL EMERGENCY MANAGEMENT AGENCY
PAYMENT INFORMATION FORM
Community Name: Coppell, Texas
Project Identifier: St. Andrews Estates
THIS FORM MUST BE MAILED, ALONG WITH THE APPROPRIATE FEE, TO ONE OF '1~O POST OFFICE BOXES (SEE BELOW) OR FAXED TO
THE FAX NUMBER BELOW.
Type of Request:
MT-I application fee ~
MT-2 application fee .]' (Insert 3173 as the P.O. Box number in the address below)
Extemal Data Requests (EDRs) (Inse~t 39~ as the P.O. Box number in the address below)
Federal Emergency Management Agency
Revisions Fee-Collection System Administrator
P.O. Box 3173
Merrifield, Virginia 22116
Fax: (703) ~49-~282
Request No.: (if known)
Amount: 80000
[] INITIAL FEE* [] FINAL FEE [] FEE BALANCE** []
*Note: Check only for EDR and/or Alluvial Fan requests (as appropriate).
**Nste: Check only if submitting a corrected fee for an ongoing request.
COMPLETE THIS SECTION ONLY IF PAYING BY CREDIT CARD
MASTER CARD []
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
CARD NUMBER
VISA[] CHECK [] MONEY ORDER
EXP. DATE
Month Year
Date
Signature
NAME (AS IT APPEARS ON CARD):
(please print or type)
ADDRESS:
(for your
cmd~ card
mceipt-pleass
l~fnt or type)
DAY-rIME PHONE:
FEMA Form 81-107, Payment Information Form
S'[t~ANDRI~WS LAND COMPANY, LTD.
DATE INVOICE NO DESCRIPTION
2-22-05 022205
ST. ANDREWS EST - C
CHECK
DATE
CHECK
2 - 28 - 05 NUMBER 908 TOTALS
800.00
.00
800.00
Pay:
PAY
TOTHE
ORDER
OF
ST. ANDREWS LAND COMPANY, LTD.
2629 DICKERSON PKWY. STE. 110
CARROLLTON TX 75007
¢9721 242-1770
GRAND BANK
DALLAS. TX 75:370
************* ....... *********************** hundred dollars and no cents
DATE
February 28, 2005
NATIONAL FLOOD INSURANCE
II'O00qOBll' ':~02~5~1:2D O5~?
CHECK NO~ AMOUNT
90 Y/* ....... 800.00
9O8