1955 Francis Ave RES21-0217 Form Board Elev Cert FORM BOARD ELEVATION CERTIFICATE
DATE: r z 20 ) zoz
PERMIT 7° _
37
NUMBER: SJ0 2[ 7
ADDRESS: 19Sc Frar,c�S A�� 31233
REQUIRED FINISH FLOOR ELEVATION ON CITY
APPROVED SITE PLAN: l3.sd
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE: 13, 53
SURVEY COMPANY
NAME: :DIE C ,1;1 s)-Scivvtisic9 , LLC
SIGNATURE OF SURVEYOR:
LEGACY , In-Place Density Tests:
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ENGINE ; RING 9 INC Subdivision / Lot Number: 1V- .
itAct t UL 4 33 O
Geotechnical&Materials Engineering and Testing (Address if no lot number)
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TIMI�� ok Location Lift/Depth % Max Density
♦ vt4-- w c L' 5E--,,,
_Ak LcJ+L3&Li Sc i4
The above tests meet the specification requirements - Pass COY Fail 0 (if fail,see notes below) S
Notes:
This report has not been reviewed by an engineer, - ,;( --: ', ="'stP' 1,., J
the final report can be found at Le ac Re orts.com - �. i5 L ''+ v‘,-
Date Tested: —(1-2( it * TS®CM
Tested By: ?.. h!��'(a - -.� C` FAST & EASY ONLINE ACCESS
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6424 Beach Boulevard, Jacksonville, FL 32216 -2904-721-1100