BP5456~%J~ILDING PERMIT APPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date:
~I -Z3-~3
CATION
Permit 5 4 5 6
Issue Date: ~-~ '~ Permit Fee: $ ~~ ~ CjC~
JOB ADDRESS n ~
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LEGAL
1 ' DESCR. LOT N0. BLK. TRAC
^ SEE ATTACHED SHEET
2. OWNER r ~ ~ ~~~~ ~ MAILADDRESS ZIP PHONE
3. CONTRACTOR
t~-n 9-~
~2e/1 C MAILADDR SS PHONE LICENSE NO.
~ ~ Z ~~ ~~ ~/c~
USE OF BUILDING
4.
5. Class of Work: ^ NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work:
7. Sq. Footage of Structure (Including Basement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodway Yes ^
10. Floodplain: Fringe Yes^ No ^
No ^ Dev. Permit
BFE EIev.Cerl.
11. Current Zoning:
12. State Fire Marshall Required: Yes ^ No^
13. Special Use Permit Required: Yes ^ No ^
14. Variance Required: Yes ^ No ^
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes ^ No ^ Waiver Approved _
APP L ATI(~ A~~P~ AED BY I PLANS CHECKED BY I APPROyED FOR I~ BY I
i NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I achnowledge that payment of the
building permit application fee does not constitute issuance of this building permit. I further
agree that construction covered by this permit application shall not be commenced until I
have received acopyof this application form signed bythe Building Inspectorand stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the speafications set forth
above and in accordance with the codes~ordinances of the City of Blair and the State of
Nebraska. I understand that this permit is void if work is not commenced within 180 days
or isnot completed within 2 years of date of issue~J
OF OWNERICONTRACTOR OR AUTHORIZED AGENT DATE
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sir Water Service
Remote
Building
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in ABC _
Final
Ground Work Plumbing
SIGNATURE OF OWNER (IF OWNER BUILDER) pA7E Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Appro e By: ~ ~`
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Lt)CATION
DATE
June 19, 1993
TO'
Wayne Smith
1850 Park St.
Blair Ive,68008
HOLE 1
J&L TESTING SERVICE
RT. 2 BOX 227
BLAIR NE. 68008
(402) 426-4851
HOLE 2 HOLE 3
TIME FILL ADIIVG LOSS FILL ADING LOSS FILL EADIlVG LOSS
5:00 6" 6" 6"
5:30 6" 1.75" 4.25" 6" 4" 2" 6" 3" 3"
6:00 6" 2" 4" 6" 4" 2" 6" 2" 4"
6:30 6" 2.75" 3.25" 6" 4.25" 1.75" 6" 3" 3"
7:00 6" 2.5" 3.5" 6" 3.75" 2.25" 6" 2.5" 3.5"
7:30 6" 2.75" 3.25" 6" 3.75" 2.25" 6" 2.5" 3.5"
8:00 6" 3" 3" 6" 3.5" 2.5" 6" 3" 3"
8:30 6" 3" 3" 6" 3.75" 2.25" 6" 5~ 3.25" 2.75"
9:00 3" 3" 3.75" 2.25" 3.75" 2.25"
27.25" 17.25" 25.5"
I~~~~~ ~~
SOIL ABSORPTION TEST DATA REPORT
PROPERTY WHERE SOIL TESTED: Owner ;W~tyne Smith
Location: Township: 19 Address:l~park St.
Section 14 ~La1ri Ne.68008
Range 11
SOIL TYPE :Silty clay Silty clay loam, Sandy loan~.b
Silty loa.~.s.,. Clay loam ~1 Sandy clay
Dates of test :June 18F 199' to J mp 19* 99~ ~ Weather : Precip:None. Temp:~5
PERCOLATION TEST DATA FILE
A B C D E F G H I J K L M
HOLE PRESATUAATIO N PERIOD PRCOLATION READINGS RESULTS
DEPTH STA RT EN D START EN D f]apsed Waiver level PercalaGan
m i r~A'in ~ m i r-min m im r-rnin aterlevel im r~nin aterLevel Time min Dro m ales mini
4T 618 7:OD
PJiA. 6.19 5:00
AJ~A. 8.19 5:09
AJr1. 6' 9:00
A.B. 3.0' 240 2715' 8.81
422" 618 7:00
PJd. 619 5:00
AJd. 619 5~D
AJiA. B' 9~D
AlA. 3.75' 240 1715' 13.91
48'
xn 618 1:OD
P.Af. 619 5:00
A.til. 619 5:00
A.B. 6' 9'00
A1~. 3.75' 240 25.5' 9.41
w+v
{" , ,~/
ignature of person conducting test
Addresg:RR#2 HOX 227
Phone: 426 - 4851
Sum of precolation rates: 32.13.
Average of rates: 10.71.
Inches per minute: 11.24.
~Q ~i ~ 40 50 60
CITY INSPECTION SLIPS
Inspection has been requested for - ~~~ l ~ J G
Locat' n of Building
By dhn ~ ~~-
Name of Company
On _ G
(Type of Inspection)
At ~ Cv' /~ ~~~~
bate Time n
Results of the inspection are: ~(/
Ci y Representative
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