Form Board Survey Form printable pdf download

Form Board Survey Form

FORM BOARD SURVEY FORM

Please Complete All Fields. Incomplete Forms Will Not Be Accepted or Reviewed. Thank you

DATE:

[

MANDATORY]

PERMIT #:

PROJECT #:

: ___________________________________________

PROPERTY OWNER NAME

________________________________________________

PHYSICAL ADDRESS:

PARCEL #: _______________________________________________________

LICENSED CONTRACTOR INFORMATION :

:_________________________________________________

COMPANY/QUALIFIER NAME

:____________________________

LICENSE #:___________________ CONTACT PERSON

OFFICE #:_____________________ CELL:____________________ FAX:____________________

(Check one)

RESIDENTIAL________ COMMERCIAL_________MULTI-FAMILY____________

(Check one) Indian River County_________ City of Vero Beach____________

**ALL PERMITS MUST BE IN ISSUE STATUS @ TIME OF SUBMISSION, OR THEY WILL BE DISCARDED**

FOR OFFICE USE ONLY

REVIEWED BY:________________

DATE:___________________

RESULTS:

___________ APPROVED

____________ REJECTED

REJECTIONS:

______________SETBACKS

_____________ELEVATION

___________BENCHMARK IS MISSING

NOTES:

CONTACTED: _____________________

DATE: __________________

REVIEWER: ______________________

DATE:__________________

KPA/ 10/9/06

Form Board Survey Form