586 Timber Bridge Lane FORM BOARD ELEV FORM BOARD ELEVATION CERTIFICATE
Duval County / Clay County
, Left copy on site I I No box
Lot and Subdivision:
DATE: ,!v /0- it)
PERMIT
NUMBER: ibc,(1
ADDRESS: sty
REQUIRED SLAB ELEVATION ON CITY
APPROVED SITE PLAN:
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)