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. . � � <br /> ��.���,� .��;�� ����;�,� ..- � <br /> 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 Iimit.J <br /> Date of Survey: �— ,��� � � PERMIT# � `"� <br /> Property Location Surveyed: �����V� �1�1w1 I ��_g�7�1� �r�� <br /> (address and/or parcel#) � `� oa5�3��o�ol3D� <br /> Description of Bench Mark: �ll�� �j, Sl D� �� P�A�J1 E N��@,��,�� <br /> Bench Mark Elevation: 4-��� (pE ,���-�� �G�� <br /> BOX 1 BOX 2 <br /> A=�B= Z� Q Highest point of the <br /> C= �,,2 sidewalk EL <br /> D=��� �p� <br /> A+B+C+D = l,�,y' /4= �rJ�Average Base Elevation *Submit a map showing <br /> the location ofthe highest <br /> + Maximum Height of�(feet) point of the sidewalk <br /> _�,�Maximum Elevation Allowed abutting the property. <br /> Check: <br /> BOX 1 � I, ���L1.1'�, , certify that I measured the grade at the <br /> midpoints of the proposed structure at the�undisturbed ground elevations/ Dapproved <br /> topography elevations for the property above. <br /> BOX 2 ❑ I, , certify that I measured the highest point <br /> of the sidewalk for the pr aue._�� <br /> � L , <br /> .�15- 17 <br /> Signature of urveyor Date �-�-�---�;.--�._.,,,_,,,�„ ,���y�' <br /> . . . ^ . <br /> p Y BT SURVEYS � � 4 <br /> Com an �y ' <br /> � :a. E ,\ <br /> 12415 9th Drive SE °��`� ``�- j��` ``' <br /> Address :�, �'`' . `'• �� <br /> S �, <br /> Everett WVA 98208 +�� �� 'V � ,, <br /> ' 3 t�? ,�s . � �;' � <br /> � 1�+c • .F*`�Y; �.E�.�,✓t._�i Vy .,��+.�/� <br /> Phone/Email �� ���-- ��,�0 : eal'�•�����;' `''"����'�`> <br /> " `�-�. �i_,,�P�:1- <br /> � -:....�. <br /> ! E�PiRES 1/11{.�j� <br />