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OCT1 8 2023 BLit i ing;I:tgi,l i landou t - <br /> CITY OF EVERETT <br /> Permit Services Base Elevation Survey <br /> (For Surveyor Use Only IF a survey is required. Instructions:Complete this form to determine the average base <br /> elevation of the proposed footprint or to locate the highest point of the sidewalk, whichever applies. This form is to <br /> be submitted with the building permit application.Include these calculations on the site plan and building plans. <br /> During framing,the Height Survey form will be required for the framing inspection. Contact the Planning <br /> Department at 425.257.8731 if the structure does not meet the height limit.) <br /> Date of Survey: l d/4/20;3 3 PERMIT# <br /> Property Location Surveyed: <br /> (address and/or parcel##) <br /> Description of Bench Mark: L- ) <br /> Bench Mark Elevation: `91 <br /> BOX 1 BOX 2 <br /> A= 5a/. 6'o <br /> B= S�/. 6 Highest point of the <br /> C= of? /, .4t sidewalks ,j 02 EL <br /> D= !r , `70 A5f* ivv �,r.•� . <br /> 2cri,,S7/4= S gmap showing <br /> A+B+C+D= O/,6 vera e Base Elevation *Submit a <br /> the location of the highest • <br /> + Maximum Height of 243 (feet) point of the sidewalk <br /> = 5 L. ,64 Maximum Elevation Allowed abutting the property. <br /> Check: <br /> _ <br /> BOX 1 D I, b4'0 :-'& -* , certify that I measured the grade at the <br /> midpoints of the proposed structure at the gundisturbed ground elevations/ ❑approved <br /> topography elevations for the property above. <br /> BOX 2 ❑ I , ,/' (, ., y',, certify that I measured the highest point <br /> of the sidewa roperty abov f/$'P'i (&: <br /> /©/ /z 3 <br /> nature ilfveyor Date <br /> 1 G. wEs <br /> Company � �. G % I <br /> /�r� t -c . .of ►Ask;.1141 <br /> f'ycj <br /> • <br /> Address - ,+.ydSs ; _ x <br /> — <br /> 0 <br /> �w nt�il t U/o/J 4j- '1 1/?/ *AI, Law <br /> J A N 3 0 2024 <br /> CITY OF EVERETT l�a <br /> Permit Services <br />