362 Plaza form board elevation certificate FORM BOARD ELEVATION CERTIFICATE
DATE: vl fZz/zo y
PERMIT
NUMBER: R4S3 1 -7 - 4PO79
ADDRESS: 3!s z 72-4 z,e, s :C An. ,✓n L �G w 3 7-2 3 3
REQUIRED FINISH FLOOR ELEVATION ON CITY
APPROVED SITE PLAN: y'0
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE: �3
SURVEY COMPANY
NAME: sr�r�eN u,/ A45cwA�,
SIGNATURE OF SURVEYOR:
LAJ"
A:.;;
9556 Historic Kings Road • Suite 201
p Jacksonville, FL 32257
eS FIELD DENSITY TEST REPORT
Phone: (904) 886-0766
OF1AX,INC. Email: twheeler@agesofjax.com
AGES JOB NO.: —S-I-1 9v�f DATE TESTED :
JOB NAME: .362, P REPORT DATE:
CLIENT : Co I c t3,.,:td tit TECHNICIAN : SAn� M AAA
LOCATION: a G RA< REPORT NO. :
Test Moi#ttre Wit.. Ivry
Na. Content Density Density, Number , A+ iiaaretE.; f equlr ps;; all Test'Location Elevation Test Datum
fpco (PCO x Feet
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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
Type Number Density Moisture Soil Type herein is representative of compaction achieved at the specified test AGES OF JAX, Inc.
location and depth. Passing density tests should not be construed to be a
Proct S (pcfl 01.4%) it f'r "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