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JUhl-03-98 WED 13:27 SEILER-&-KELLER 305 822 9539
F. 02
FINAL EL'.1
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NOLD I
7 zis cjttWcaje ~Uill nrzt be accented if all items are not cornplefed
PROPERTY INr OR ATION
Cnh tollowing information to he provided by cantmet,or, prope"ly owner or agent.)
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New Cons:.`uction Additi.ot), Recorlstrzuion or
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LOWEST
ADJACENT GRADE ELEVATION T _:tON' . . .
GARAGE
OR STORAGE - FLOOR ELEV TIOll
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14. G. V . D.
MEVATIMT OF HXGIi. `ST CR0r,,TT OF ROAD (Fmnu-ng Pmxnf), .
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(1'roFide top e.arou of supQc>ttutz structure),
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Data
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This form has been approvcd by The Fc-.4c _i EmergCncy Managcmcnc.kgeacy (FEM k) %nd may be used for 7ood 4-suranc; pur',,ls'-'s-
Rer. lly 3l. 1Q95i~i_EVCERT.193