Don't confuse two separate systems - datum (elevation), and coordinate system (horizontal) - it's the two combined that place your project into "real" space, on the Earth.
So for example, and each locale is different because of their particular magnetic North, geodetic calculations, etc., we primarily use NGVD 29 datum, with a coordinate system of FL83-WF (or Florida State Plane, West Zone, US Foot)... This helps me to consume available resources, such as County GIS (not as accurate as formal survey, mind you), Aerials, Lidar, Benchmarks, etc., within the confines of a given project's boundary.
[Edit] - This may help: Civil 3D -
Specifying Units and Zone Settings