1892 Sea Oats Dr RES23-0008 - Elevation Certificate FORM BOARD ELEVATION CERTIFICATE
±wal Count / Clay County
Left copy on site V No box
Lot/Subdivision: Lor /3 (St_K Z SFL.,. + \(4KI- (
DATE: as-oy-Zin2-3
PERMIT
NUMBER: mn
ADDRESS: 189z 5E4 04-rs
REQUIRED SLAB ELEVATION ON CITY
APPROVED SITE PLAN: /0.56,
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE:
SURVEY COMPANY NAME:
Bartram Trail Surveying, Inc.
1501 CR 315, Suite 106
Green Cove Springs, FL 32043
SIGNATURE OF SURVEYOR: (Party Chief)