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1 <br />< <br />13uilJin�_ I Iri��ht Handc�u� -Pu�c 3 0l� -i <br />C'ih of E�•erctt, �1'.-1 <br />Base Elevation Survey <br />(Fnr Surveyor Use �nly IF a survey is required. Mstructior�s: Complete this forn� tv determine ihe average base <br />elevniion nf [he propr�seci fonrnrint or to locnfe the lirghest poinr of the side�vnik, whichever opplies. This form is to <br />be submii�ed �vith tiie buildrny permit npplicatin». Incicrde these calculations an the site plan ond building plans. <br />Durinr fr��n;inr;�, ti:e 1-ieigh[ Survey form wiil be r�c�uired for the framing inspec (;on. Contoct ihe Pianning <br />Depnrtment a; 425.257.�731 ;f the srruccure does not meet the hei�ht limit. J <br />Date of Survey: <br />Property Location Surveyed <br />(address and/or par-cel r) <br />Description of Bench Mari<: <br />����/� � �✓� �p 4- PERMIT # <br />S'/C7 <br />�� <br />� l�v i) C �-I (lL �!/C' /' f' ��Z � (L.o� <br />C'i �i .�� f <br />fr t��.s��2 �T��'�,5� ���c.? �f�: ���F ���i <br />, <br />Bench Marl< Elevation: zl� ], C,�GO � <br />BOX 1 <br />A = ;� r/, dh�:3 <br />B = 2itv.a /v <br />C=Z/�•€'C� <br />n=2E� -.�� <br />A-B+C+D = � �%� ��/ 4 - .2i ,3. O � AveraUe Base Elevation <br />+ Maximun� Height of 2h' � (feet) <br />_ ��fr � C"L. Maximurt� Elevation Allowed <br />BOX 2 <br />Higfi t point of th <br />sidewa EL <br />*Submit m showing <br />the lo ation of e hi�hest <br />po' t of the side�v <br />utting the property. <br />Check: <br />BOX 1� I, _�C�r wt (� �%'� Cc� -� , certify that I measured the grade at the <br />midpoints of the proposed structure at the�ndisturbed ground elevations / Dapproved <br />topobraphy elevations for the property above. <br />eox 2 ❑ i, -_- , <br />of the sidewail< for the property above. <br />� �� �'' ��'_ <br />Signature of Surveyor <br />Company <br />Adciress <br />certify that I measured the highest point <br />��1. 7�b �' /Vor%�Y� 5 � � L�: <br />S'� c!1G ���-/)'our !"��r17� CJ��/L! <br />� �' / � <br />��� J�_--- <br />Phone/Einail _�2S• %[�.3 ' �.4 5U <br />_,t�lG��r-�- i�ac�'f"/7 crJt�7" � <br />G�c:� n'! c: �( S f'. f1 �� <br />� .� �U, z �,s-� <br />----, <br />Date <br />c�� <br />