1804 Atlantic Beach Dr form board elevation certificate -sem
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FORM BOARD ELEVATION CERTIFICATE
Duval :County / Clay County
Left copy on site F-1 No box
Lot and Subdivision: �oT del eZo�-u --Z AFPk f
DATE: 0-0-7- 16
PERMIT
NUMBER: �b SF0. 203
ADDRESS:
REQUIRED SLAB ELEVATION ON CITY
APPROVED SITE PLAN: %3,3d
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)