Penfolds-RS030114
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F :RAL EMERGENCY MANAGEMENT AG ';Y
NATIONAL FLOOD INSURANCE PROGRAnIl
ELEVATION CERTIFICATE
a.M.B. No. 3067-0077
Expires July 31, 2002
. ~m rtant: Read the instru~tiol18 0.. a es 1 - 7.
SECTION A. PROPERTY OWNER INFORMATION
For Insurance Company Use:
Policy Number
BUILDING OWNER'S NAME
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No,) OR P.O. ROUTE AND BOX NO.
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CITY STATE
C01l'feLl.... ""f"aA 5
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
L.()T Co ~ & TH-e 12B'se:!2Je--
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.)
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LATI UDE/LONGITUDE (OPTIONAL)
( ##0 _ ##' _ ##.. or ##.#####0)
Company NAIC Number
ZIP CODE
750 If'
HORIZONTAL DATUM:
~D 1927 LI NAD 1983
SOURCE: LI GPS (Type):
LI USGS Quad Map LI Other:
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SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER
t.a 0
B2. COUNTY NAME
B3. STATE
84. MAP AND PANEL B5. SUFFIX B8. FLOOD
NUMBER ..... ZONE(S)
4tOtI'3eO .,J C
B 10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
I_I FIS Profile I$.FIRM LJ Community Detennined 1-' Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: I~GVD 1929 I_I NAVD 1988 1-' Other (Describe):
B12. Is the building located in a Coastal_Barrier Resources System (CBRS) area or Otherwise Proteded Area (OPA)?
Designation Date:
B9. BASE FLOOD ELEVATION(S)
(Zone AO, use depth of flooding)
o
I_I Yes ~o
SECTION C . BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: LIConstrudion Drawings* I~uilding Under Construdion* I-'Finished Construdion
*A new Elevation Certificate will be required when construdion of the building is complete.
C2. 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.)
C3. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH, ARlAO
Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from
the datum used for the BFE in Sedion B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Sedion G, as appropriate, to document the datum conversion.
DatumfJMJD 142)f Conversion/Comments '1Q.o "'~t! "8" -=N~\tJa~
Elevation reference mark used 15M- 448. "lS Does the elevation reference mark used appear on the FIRM? 1-' Yes 0
(J a) Top of bottom floor (including basement or enclosure) .501 . M ft.~ cij
GI
(J b) Top of next higher floor 1J1>r . _ ft.(m) ~
(J c) Bottom of lowest horizontal strudural member rv zones only) ~'Jr. . _ ft.(m) ! ~
(J d) Attached garage (top of slab) 1.14- . _ ft.(m) ~-g
(J e) Lowest elevation of machinery and/or equipment ~:
servicing the building ')Ir . _ ft.(m) ~ ~
(J f) Lowest adjacent grade (LAG) 50~ .25.. ft.~ ~ cW
(J g) Highest adjacent grade (HAG) 5"0 ~ . ~ ft.(m) ~
(J h) No. of penn anent openings (flood vents) within 1 ft. above adjacent grade . \J".. ~
(J i) Total area of all pennanent openings (flood vents) in C3h Ilk sq. in. (sq. em)
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 infonnation.
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 that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
~~s.r~~4i LICENSE NUMBER 3c-t:t (
TITLE~e2- 0e6
ADDRE ~^ ~ _ , D CI STAT!,.... ~
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SIGNATUR DATE TELEPHONE .., A....~
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SEE REVERSE SIDE FOR CONTINUATION
REPLACES ALL PREVIOUS EDITIONS
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IMPORTANT: In these spaces, copy the c,-, . esponding information from Section A,
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX,NO,
For Insurance Company Use:
Policy Number
STATE ZIP CODE Company NAIC Number
1 0
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
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SECTION E. BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONEASWlt.HOlJT.s~E)
For Zone AD and ?one A (without BFE), complete Items E1 through E4. If the Elevation Cerlificate,is intended for use as supporling
infonnation for a ibMA 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 of the bottom floor (including basement or enclosure) of the building is LI_I ft.(m) LLlin.(cm) LI above or LI below
(check one) the highest adjacent grade. ,,' i.':j..
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor-or elevated floor (elevation b) of the building is
LI_I ft.(m) 1_1_lin.(cm) above the h!ghest adjacent grade. . .
E4. For Zone AD only:'lf no, flood depth rll~lT)ber is available/1&' the tQlj Ql t}1e b~orn1!P9r el~va'~ in~accordance with the ~~muni~ "', ,
floodplain management ordinance? I_I Yes LI No LI 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 AD must sign here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS
CITY
STATE
ZIP CODE
SIGNATURE
COMMENTS
DATE
TELEPHONE
I Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or'o/~~rweJC? ~~,!,inist~r the ~ro~n!lY:.s, floodplain management ordinance ~n cofP!ete
Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item($~an~iin belc?,w...
G 1. I_I The information in Section C was taken fro~ oth~documentation that has been signed' and emoo'Ssed 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 below.) "
G2. I_I A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or
Zone AD.
63. I_I The following information (Items G4-G9) is providep for community floodplain management purposes.
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G4. PERMIT NUMBER G5. DAT-E P6R IT IS . ED- G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
'-. ISSUED
G7. ThiS'permit has been issued for: LI New Construction LI Substantial Improvement
G8. ElevatiOR of as-built lowest floor (including basement) of the buil~ing is:
G9. BFE or (in Zone AD) depth of flooding at the building site is: '
LOCAL OFFICIAL'S NAME
. _ ft.(m) Datum:
. _ ft.(m) Datum:
TITLE
COMMUNITY NAME
TELEPHONE
SIGNATURE
DATE
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COMMENTS
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I Check tiers if attachments
REPLACES ALL PREVIOUS EDITIONS
FEMA Form 81-31, AUG 99
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RE VIE WED ~~ W~..o,.~LB~~'T
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BY ~ DATE
ApprOval of the plans andspecifi'Cations shall not be
construed to mean construction in direct conflict
with the City ofCoppelJ Building Codes and Zoning
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liTE PLAN
SCALE: '".:20'-0"
LOT 10 BLOCK B
THE RESERVE
CO~~EL.L., TEXAS
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