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1505 RICHARDSON LN FORM BOARD ELEV FORM BOARD ELEVATION CERTIFICATE DATE: W- -2u21 PERMIT NUMI3ER: % L ) \ 1 ADDRESS: 150 L7) 3z2," REQUIRED FINISH FLOOR ELEVATION ON CITY APPROVED SITE PLAN: ( 1;_,9 ACTUAL ELEVATION OF FORM BOARD OR GRADE STAKE: I `j 3 SURVEY COMPANY NAME: /-m71 /1,'Lz_). Sciivc (0 SIGNATURE OF SURVEYOR: G� FORM BOARD ELEVATION CER R s I ` 1/4„ATE DATE: C -20,3 PERMIT NUMBER: ES21 - (� ADDRESS: ) fio) Ric__-(jSump2233 REQUIRED FINISH FLOOR ELEVATION ON CITY APPROVED SITE PLAN: j , y ACTUAL ELEVATION OF FORM BOARD OR GRADE STAKE: / 9,,y 3 SURVEY OMPANY NAME: �� � v, ivrt./( ,) u G SIGNATURE OF SURVEYOR: (j 'd' - -- 9556 Historic Kings Road • Suite 201 C a g e Jacksonville, FL 32257 FIELD DENSITY TEST REPORT \/V Phone: (904)886-0766 OF JAX,INC. Email: twheeler@agesofjax.com AGES JOB NO.: 17 4 2.,I DATE TESTED : JOB NAME: I S o '7 p :r y, ,.,,A so, 1_,-, REPORT DATE: CLIENT : A c H TECHNICIAN : LOCATION: REPORT NO. : Test Moisture 2 : Proctor �Iei t1Ve C e.. 1 No. Content 1 ,Donut;: Number Density Achieved Require�dass/Fait Test Location Elevation Test Datum 1961 jper) (PO toot) (%) 1�) .. (Feet) U i- , 7. 5 J -47 , t" 4 i G j 1- , l< 'H - i c n G - i " .4-< ,I V • s , 4, '6, • L 9 2 t,,_-r- ;cr S---(4-2,(.1.-. • PROCTOR INFORMATION SUMMARY: The relative compaction results are a quality control measure of the This report shall NOT be reproduced, Proctor Max. Dry Optimum adequacy of the fill and/or sub-grade compaction effort. The data shown Except in Full, without written approval of herein is representative of compaction achieved at the specified test AGES OF JAX, Inc. Type Number Density Moisture Soil Type location and depth. Passing density tests should not be construed to be a Proct /n / S (pcf) (%) "certification" of suitability of the "subsurface soil conditions" and/or an evaluation of the ability of the subsurface soils to adequately support the REPORTED BY: planned construction. AGES OF JAX, Inc. agrees to keep confidential any and all matters related to these test results and understands that unauthorized disclosure Remarks of these test results to anyone other than our clients, or their designated TIMOTHY R. WHEELER, P.E. representative,without the client's expressed permission, is in violation of MOD=Modified Proctor Density (ASTM D 1557) AGES OF JAX, Inc.professional ethics and company policy. Registered Fla No. 42802