1629 Maritime Oak Dr Form Board Elevation Cert ,
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FORM BOARD ELEVATION CERTIFICATE
Duval County I Clay County
Fl Left copy on site No box
Lot and Subdivision. (.3 8 k6q 411, oroo p9tl�� y
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DATE:
A�lE' 0 y ' l 9--' �Z
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P ERtIM 11
Nl. : vu1i L S zz - 0918
ADDRESS: GZ7 A � / � IMt vUN r.
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S11 AR F' ON CTTV
:LPPROVE.D SI IT PI .A\ .
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE: (Z • 1S
SURVEY COMPANY
i NAME: Bartram Trail Surveying, Inc.
1501 CR 315, Suite 106
Green Cove Springs, FL 32043
SIGNATURE OF SURVEYOR: (Party Chief)