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FLOODPLAIN CERTIFICATION (Accessory Bldg.) <br /> To Be Completed By Wisconsin Registered Surveyor or Engineer <br /> k i : ;I . ,,i >> 7 (;SM V 2,135 <br /> Owners Name Legal Description p <br /> Address ` '� { )f ; , Computer Number ')18333505110 <br /> County Land Use Permit Number <br /> RFE For Building Site 956 Clam Lake NAVD88 <br /> '414 <br /> s <br /> E <br /> ae <br /> Accessory � <br /> (B) Ground Elevation a Bldg. <br /> At Top of Fill Distance Beyo <br /> Building a (D) Slab Elevation <br /> • (C) suenw <br /> e <br /> (A) Ground Elevation <br /> At Building Site `L <br /> Vertical Datum NAVD88 <br /> (A) 2 <br /> Vertical Control <br /> Monument Referenced Clam Lk 1 (B) 955 8 <br /> Eley = 955.64 [NAVD881 (C) 0' <br /> Used Broberg site BM @ 956 (6530 STH 70) (D) 956 Top of Slab <br /> Comments <br /> I hereby certify that the information Name Douglas R Crane — <br /> provided on this form represents <br /> the actual building elevations as Signature <br /> current) constructed. <br /> Registration Number VVI-1511 <br /> Date _... July 29, 2022 <br />