Carter-RS050815
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FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
Q,M.B, No, 3067-0077
Expires December 31,2005
ELEVATION CERTIFICATE
SECTION A. PROPERTY OWNER INFORMATION For Insurance Company Use
BUILDING OWNER'S NAME Policy Number
BUilDING STREET ADDRESS (Indudlng Apt, Unit, Su~e, andlor Bldg, No.) OR PO, ROUTE AND BOX NO, Company NAIC Number
517 CARTER DRIVE
Important' Read the instructions on pages 1 .7,
CITY STATE
COPPELL TX
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 15 BLOCK A TRINITY SHORES ADDITION LOTS 1-19 BLOCK A
BUILDING USE (e.g., Residential, Non.residential, Addition, Accessory, etc. Use a Comments area, if necessary)
RESIOENTIAl
LATITUOE/lONGITUOE (OPTIONAL)
( ##", ##' ,##,##" or ##_')
liP CODE
75019
HORIZONTAL OATUM:
[8J NAD 1927 D NAD 1983
SOURCE D GPS (Type):_
D USGS Quad Map
[8J Other FIRM
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1, NFIP COMMUNITY NAME & COMMUNITY NUMBER B2 COUNTY NAME
COPPELL 480170 DALLAS
] B3 STATE
TEXAS
--I
i 84, M<\P AND PANEL B7, FIRM PANEL 89, BASE FLOOD ELEVATION(S) I
I NUMBER B5, SUFFIX B6, FIRM INDEX DATE EFFECTIVEiREVISED DATE B8, FLOOD ZONE(S) (Zone AO, use depth of flood'''ll
I 48113C0155 J 116,1&(J5 08,23-01 XAE 4670 I
B10, Indlcale the source of the Base Flood Elevation (BFE) data or base ftood depth entered In B9,
D FIS Profile IZJ FIRM D Community Determined D Other (Describe):_
B11,Indicalethe elevation datum used for the BFE in B9: IZJ NGVD 1929 D NAVD 1988 D Othe'(Describe):_
B12, Is the building located In a Coastal Barrier Resources System (CBRS) area or OtheMse Protected Area (OPA)? D '(es I2J No DeslgnaUon Date_
SECTION C . BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1, Building "evatlons are based on D Construction Drawings' IZJ Building Under Construction' D Finished Construction
"A new Elevation Certificate will be required when constructiOll of the building is complete.
C2, BUilding Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being comr,leted ,see pages 6 and 7, If no diagram
accurately represents the building, proVide a sketch or photograph,)
C3. Elevat,ons - Zones A 1,A30, AE, AH, A (with BFE), VE, V1-V30, V (With BFE), AR, ARIA, ARlAE, ARIA 1-A30, ARlAH, ARJAO
Complete Items C3.-a,1 below according to the building diagram specified in Item C2, State Ihe datum used, If the datum i,; different from the datum used tor the BFE In
Section 8, convert the datum to that used for the 8FE. Show field mE..dSUrements and datum conversion calculation Use the space provided or the Comments area of
Section 0 or Section G, as appropriate, to document the datum cooversion,
Datum NGVD1929 Conversion/Comments BM PROVIDED BY NEEDHAM, WRIGHT ENGINEERS
Elevation reference mark used _Does the elevation reference mark used appear on the FIRM? DYes IZJ No
tl a) Top of bottom fioor (including basement or enclosure) 475" 05ft,(m)
"b)Topofnexthigherftoor 476 , Jl.ft,(m)
" c) Bottom of lowest horizontal structural member (V zones oniy) NA ,_ft,(m)
" d) Attached garage (top ot slab) 476" lLft(m)
" e) Lowest elevation of machinery andlor equipment
seNiclng the building (Describe in a Comments area) NA ,_ft,(m)
" D Lowest adjacent (finished) grade (LAG) 474, Q.ft,(m)
" g) Highest adjacent (finished) gr<~je (HAG) 475, Q.ft,(m)
" h) No, of permanent openings (fiood vents) within 1 ft, above adjacent grade NA
" i) Total area of all permanent openings (ftood vents) In C3,h f:!6...sq, In, (sq, em)
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SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFIC ATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify :llevation information.
I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand thai any false statement may be punishabte by fine or impnsonment under 18 US, Code, Section 1(101
CERTIFIER'S NAME BARRY RHODES LICENSE NUMBER 3691
COMPANY NAME BARRY RHODES
TITLE OWNER
ADDRESS
7509 PENN RIDGE
SIGNATURE
CITY
ROWLETT
DATE
08-15'()5
STATE
TX
TELEPHONE
972475-8940
ZIP CODE
75088
See reverse side for continuation.
Replaces all previous editions
IMPORT ANT: In these spaces, copy the corresponding information from Section A For Insurance Company Use:
BUILDING STPeET ~DDRESS (Indudi!'(J ~pt Un~ Suite, and/or BIdg No,) OR P.0 ROUTE AND BOX NO, POlicf Number
,')17 CARTER DRIVE
CITY ST~TE ZIP CODE Company N~IC Number
COPPELL TX 75019
SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community offidal, (2) insurance agentloompany, and (3) building owner.
COMMENTS
o Check here if attachments
SECTION E. BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AD and Zone A (Without BFE), complete Items E1 through E4, If the Elevation Certilcate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
E1 Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph,)
E2, The top ot the bottom loor (including basement or endosure) of the building is _ ft,(m) _in,(ern) 0 aoove or 0 bEjow (check one) the highest adja:oent grade, (Use
natural grade, if available),
EJ For BUilding Diagrams 6.,<l with openings (see page 7), the next higher loaror elevated lcor (elevation b) ofthe building is __ ft,(m) _in,(ern) aoove the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
~A. The lop of the platform of machinery and/or equipment servicing the building is _ ft.(m) _in.(cm) D above or D below (check one) the highest adjacent grade. (Use
natural grade, if available),
E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor ~evated in accordance with the community's floodplain management ordinance?
DYes D No D Unknown. The local official must certify this information in Section G
SECTION F . PROPERTY OWNER (OR OWNER'S REPRESENT A TIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA-issued or community-
Issued 8FE) or Zone AO must sign here. The statements in Sections A, B, C, 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
o 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 Sections A 8, C (or E), and G of this Elevation
Certilcate, Complete the applicable item(s) and sign below,
G1. D The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information, (Indicate the source and date of the elevation data in the Comments area beiow.j
G2, 0 A community offloal completed Section E for a bUilding located in Zone A (without a FEMA,issued or communlty,issued BFE) or Zone AD
G3. 0 The following information (Items G4,G9) IS provided for community ftoodplain management purposes,
r 'G4 PERMIT NUMBER G5, DATE PERMIT ISSUED G6, DATE CERTIFiCArE OF COMPLo\NCE/OCCUPANCY ISSUED
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G7. This permit has been issued for: D New Construction D Subslantiallmprovement
G8, Elevation of as-built lowest loor (lnduding basement) ofthe building is:
G9, BFE or (In Zone AD) depth of flooding at the building site is:
LOCAL OFFICIAL'S NAME
_,_ft,(m)
__f,(m)
Datum:
Datum
TITLE
COMMUNITY NAME
TELEPHONE
DATE
SIGNATURE
COMMENTS
o Check here If attachments
FEMA Form 81-31, January 2003
Replaces all previous editions