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US/17/2eel 06:45 209NI4884 1 88a MUSEUM GRAPHICS PATE 01 <br /> r <br /> t <br /> sss-3 <br /> County Of San Joaquin <br /> Existing Elevation Certification <br /> 11. To be cotnpietcd by th*Applicant: <br /> Property Owner: +� � S Phone: <br /> J4bsite Address: "�- <br /> 'Applicant: Phone: <br /> APN: 16 <br /> B. TO be completed by Reglstered En;inrcr, Arehiled or Land Surveyor <br /> ] certify that the lowest axisting grade elevation at the proposed building site is at an, <br /> elevation of -L feet, NGVD and a grade reference has been set ata clsvatioa <br /> of feet, NGVD. g u�C e?S �tSG . <br /> *'V* ,re %t T ` <br /> Provide a sketch aneVor descriptionof grade efejcnce o on below. <br /> Elt- W*,( <br /> Pao NW <br /> Can. t'r. - <br /> 3 t <br /> affix seal or write'profcssicnal license <br /> number bciow (include expiration date) <br /> Name: <br /> Title: v of a • I <br /> Address: fi s'1�atm <br /> 5igrsatsstc: �� . <br /> Date: <br /> ew Pon.ms M"N <br /> rcr-� ioor+ooa ►t�•t t3triaossr r ��v�r�rne-��� �en�ra goo:-aa��r <br /> oZA IA& <br />