1650 E Park Terrace RES18-0304 Form Board Cert FORM BOARD ELEVATION CERTIFICATE
DATE: /2 1
2019)
PERMIT
NUMBER: R05 la —a30q
ADDRESS: 1&6o PA2K TE22ACF FA57-
AT wxi c-RFAc1 A T-( , '7,22'3
REQUIRED FINISH FLOOR ELEVATION ON CITY
APPROVED SITE PLAN: / /lot)
ACTUAL ELEVATION OF FORM BOARD OR
GRADE STAKE: I o.q y
SURVEY COMPANY
NAME: Durden Surveying & Mapping Inc.
1825-B 3rd Street North, Jacksonville Beach, FL 32250
(904) 853-6822 1 (904) 853-6825 FAX
SIGNATURE OF SURVEYOR: