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FLOODPLAIN CERTIFICATION (DWELLING) <br /> Owners Nome__ °k6 <br /> Address �(3�� r�2 LA N C <br /> �, <br /> Legal Description �,�k� _. <br /> Sfe <br /> County Land Use <br /> Permit Number <br /> RFE For qs� <br /> Building site <br /> Vertical Datum N6v b Z _ (DWELLING) <br /> Vertical Control g^ �� 13 �C7�3 (COV tej <br /> Monument Referenced .L� �! <br /> Sh QNi arsp4 i&,As4 — 6jgS,O a (D) let Floor <br /> (C) Elevotion <br /> Ground Elevation (B) Distance Beyond Building <br /> At Top of Fill <br /> E) Basement or <br /> Crawl space Elev. <br /> Ground Elevation A FILL <br /> At Building Site Q <br /> (A) k M V -`57'� COMMENTS; , <br /> (e) <br /> JSlo — `157.3 <br /> (D) <br /> (E) `�s6• � <br /> I hereby certify that the Information provided n this rm .repro is t actual building elevations as constructed. <br /> Sign' re 1r1� <br /> Reglstratton'Number 1 <br /> Date I`� bay <br />