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® Preliminary <br /> ❑ Under Construction FLOODPLAIN CERTIFICATION AWW69) GARAGE <br /> ❑ Completed <br /> To Be Completed By Wisconsin Registered Surveyor or Engineer <br /> Owners Name David & Jane Pederson Legal Description Gov Lot 2 Ser 9 T371 8W <br /> Address 15905 North 81st Street Computer Number 034150202300 <br /> Scottsdale, Az 85260 County Land Use Permit Number. <br /> 22174 Spirit Lake Road RIFE For Building Site 945.00 <br /> Dwelling <br /> / (D) First Floor Elevation <br /> (B) Ground Elevation Distance Beyond / <br /> At Top of Fill Building _ _ ___________ <br /> ------ -- - - <br /> (E) Basement or Crawl <br /> (A) Ground Elevation Space Elevation <br /> At Building Site Y �•';: <br /> (A) LAG NE corner garage 945 .2 <br /> Vertical Datum NAVD 88 <br /> (B) none placed yet <br /> Vertical Control <br /> Monument Referenced 1063-B elev. 946.85 (C) -- <br /> chiseled square left U.S. corner of (D) house let floor cabin 947.02 <br /> conc. headwall Spirit Lake outlet (E) <br /> Comments: *existing garage slab 945 .5 <br /> I hereby certify that the information Name Mark <br /> �IE. pKrause <br /> provided on this form represents �/hk.IC_ G 0 <br /> the actual building elevations as Signature <br /> currently constructed. <br /> Registration Number 1808 <br /> Date 5_i i _i n <br />