BP7205. ~ BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit_
Application Date: ~ ' ~~- ~ ~,a Issue Date: ~ '" ~~~ _~~~ Permit Fee: $ ~-~
JOB ADDRESS ~ ~ ~ I ~~ ~ ,
1 ' DESCR, LOT NO.,T~ ~ ~
!! BLK. I ~ _ ~ ~ ~ f ~ i RACT ^ SEE ATTACHED SHEET
2. OWNER
~~rma~~ MAILADDRE
u c.h~~ ~ a)~~ d~_ IP P 0 E
_~~~ 1~u ~
3 CONTRACTOR ~-°~
~" ` MAILADDRESS PHONE _ LICENSENQ.
((j r ~ l r111 r C~- ~" ~- 2C~~ ~vc~I~f ~~ • 1~~G11 /' t°OI~C~c~
4. USE OF BUILDING ~~l' I I ~~~~
' I
' , J ~`
~7 I~
5. Class of Work: ^ NEW ^
ADDITION ^ALTERATION ~MOVE ^ REMOVE.
^ REPAIR
6. Describe Work: ~SC ._-_ rnG tl~- I n -- ~ ~~f ~
], Sq. FOOtage Of StrUCtUre (Including Basement and Garage): `Z~ ~ ~ ~~~-~- ~ e p
8, Change of Use From: Change of Use To:
g, Valuation of Work: $ ~ ~~~ -
10. Floodplain: Floodway Yes ^
Fringe Yes^ No Dev. Permit
No BFE Elev. Cert.
11. Current Zoning: ~~
12. State Fire Marshall Required: Yes ^ No[~
13. Special Use Permit Required: Yes ^ No [~
14. Variance Required: Yes ^ No [~
i
15. Minimum Setbacks: Front ~ Side ~ Rear
16. Sidewalk Required: Yes^ No O'(Naiver Approved _
I APP4Py~ I~ ~ E~ I PLANS CHECKED BY I APPROVE9,F0__RJSSUANCE BY I
Site Plan Attached [r Complete Plans Attached
Approximate Completion Date
Inspections Required and Fees
Utilities ~
Sewer Tap Water Tap
Sewer Water Service ~
Septic ~ Remote ~
.~~
Building
Footings ~ Drywall
(before finish) gyp.- (p•~ 9 (D
Framing Final J 5'" 36 ~~
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. fay my signature below, I acknowledge 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 a copy of thi§ application form signed by the Building Inspector and stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the specifications 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 1 SO days,
is not completed within 2 years of the date of iss , or if work is ban ned for six (6)
n>~nthsger, w~'t~fi~v®arlie~~ ~ ~ ~~~i~ ~
SIGNATURE OF OWNER/CONTRACTOR OR AUTHORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Electrical •-° ~ ~,~.~- ~ ~E°~cM~
Rough-in `~~~1- Permanent Service ~~ ~~
Final ~ Temporary Service '
Mechanical ~ ~' "`r 15
Rough-in ~ ABC ~~
Final ~i
~ Plumbing -- ~l~ ~
Ground Work
Rough-in ~ Final ~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
#ll0l
725
POUNDS PRTO: Blair, NE Rev. Oa/B5
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
~~
Application Date: ~~
Permit Fee: $
~~7~
JOB ADDRESS ~ 1
`//~"~d~
1. LEGAL
DESCR. LOT N0. BLK. TRACT O SEE ATTACHED SHEET
2. OW - MAIL ADDRE ZIP PHONE
r3 C0 T f~ MAlll,O DR S//ll~ PHONE. LICENSE NO. }
4• Class of Work: W RESIDE TIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O REPLACEMENTS
5• Describe Work:
Comments:
PLUMBING PERMIT FEES
~~~~,~ . ~~~~
_ l Type of Fixture No. ~~~~
Kitchen .................................. $8.00 x 1
v ~ ~~• ~' ~ Bath ....................................... $8.00 x
/~
~1
~~ ~ ~ ~ ~ Rou h-In Bath
g ....................... $4.00 x ~ ~~
t Utilit
Y ..................................... $5.00 x
~G " " "`
~~ `~ ~ Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
d C-r
Water Service ........................ $10.00 ~~
NOTICE Sewer .................................... $10.00
I hereby certify that I have read and examined this Groundwork ........................... $10.00
rect
l
b
t
d
l
a
t
h /
~a
e o
pov
isio
ns of aws and
ord nances
o
vem n
this
f
P 9 g tYP Se tlC Tank & Laterals ..........
P ~ $10.00 ~
/
work will be complied with whether specified herein or not.
The granting of a permit does not presume to give authority
Lawn Sprinkler System ..........
$10.00
to violate or cancel the provisions of any other state or local
Sprinkler System ...................
$30.00
law regulating construction or the performance of (Commercial)
construction.
Permit Issuance Fee .............
$15.00 . ~. Q
~~
SIGN E OF C NTRACT OR AU RIZED AGENT
TOTAL
~~
DA E Current License on File es O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPAC,,C~'T1~iSyl,S YOUR PERMIT
Comment:
Approved
POUNDS PRTG.•Blai~, NE Rev. 12/95
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 0 2 5 7
(402) 426-4191 Permit
Application Date: ~ f'~~~
Permit Fee: $ ~ b 9~_
JOB ADDRESS
LEGAL
1 • DESCR. LOT NO. ~.
I L ~ ~ BLK.
) ~ ~ ~ j g - (~ (~ TRACT
O SEE ATTACHED SHEET
2 OWNER ~j.~~ _j_, MAIL ADDRESS
~'-l._% ~ u C~ Q ~ I ZIP PHONE
3• CONTRACT f ~ ~ r~~ f `„ ~ MAIL ADDRESS
^~' ~ ~ / ~ ^ ~ ' F{[~ ~Q / ~ ~I~/+ N~ ~~
4• Class of Work:
NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O UPGRADE SERVICE
5• Describe Work: ~) ~~ C
6• Current License on File Yes O No O NA
New Service Fee = (Amp Fee + $2.00 per branch circuit) ELECTRICAL PERMIT FEES
1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00
101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00
201-300 Amp Fee ............................ $ 30.00
301-400 Amp Fee $ 42.00
Fire Alarm System ................. $10.00
401-500 Amp Fee ............................ $ 55.00 Signs ..................................... $15.00
501-600 Amp Fee ............................ $ 67.00 Miscellaneous Apparatus ...... $11.00
601-700 Amp Fee ............................ $ 80.00
701-800 Amp Fee ............................ $ 92.00
801-900 Amp Fee ............................ $105.00 Commercial/Multi-Family and All Upgrades:
901-1000 Amp ................................. $117.00 # of Circuits x $2.00
IF OVER 1000 Amp Amp Fee
1st 1000 Amp Fee ....................... $117.00
Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total
NOTICE New Residential: (Finished Area)
I hereby certify that I have read and examined this SinglelTwo Family Dwellings
application and know the same to be true and correct. All
ZJbp sq. ft. x .045 _
I ~~ ~~
provisions of laws and ordinances governing this type of
k
ill b
li
d
ith
h
th
ifi
d h
i
wor
w
e comp
e
w
w
e
er spec
e
ere
n or not.
The granting of a permit does not presume to give authority Receptacle/Switch Outlets
to violate or cancel the provisions of any other state or local Fixtures x $.75
law regulating construction or the performance of
construction. Residential/Commercial Appliance
# Fixed Outlets x $3.00
- Power Apparatus (220 Volts)
# A
t
$3
00
ppara
us x
.
S A RE OF C
ACTOR OR AUTHORIZED AGENT
z
/ ' 7 ~ - ~ ~ Permit Issuance Fee $15.00 l S ` ~
DATE TOTAL I O ~1- S~C~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS~YOUR PERMIT
Comment:
Approved By:
POUNDS PRTG: Blair, NE fV Rev. 12/95
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 ~ ~~ ~~
Application Date: J -~ ' 9~
Permit Fee: $ Jro ~~
JOB ADDRESS
~~ 3 / ~~~2~-~+~ d~ ~
LEGAL
1 • DESCR. LOT NO.
~ ~ BLK.
,S' /E,l - °f'/$ -~/> TRACT
O SEE ATTACHED SHEET
2. OWNE~~ MAIL DDRES~ ~~L~~Ls~ ZIP PHONE
3• CONTRAG~ MAIL ADDR~S~ ^~d ~ ~. PHONE ~~ d ~f`d~ ~ SE NO.
r J
4. Class of Work: ~[df,~RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O REPLACEMENTS
5. Describe Work: - ~ ,~ .
Comments:
Gp MECHANICAL PERMIT FEES
Forced Air Systems
Per Unit Commercial/Residential (New) .............. ........................ $25.00
Air-Conditioner Unit ~p o a ~
Per Unit Commercial/Residential (New) .............. ........................ $10.00
Refrigeration Units/Coolers
Per Unit Commercial (New or Replacement) ...... ........................ $10.00
NOTICE
I hereby certify that I have read and examined this Forced Air Systems/Air Conditioner
application and know the same to be true and correct. All Unit Replacement
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not.
Per Unit Commercial/Residential (Replacement)
........................ $10.00
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local
law regulating construction or the performance of
construction. ,C'
D ~
~
Permit Issuance Fee ............. $15.00 ~
~~ ~' O
TOTAL
~ SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
~~~ `~~ Current License on File O Yes O No O NA
DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Appro~ ~ ,
POUNDS PRTG: Blair, NE Rev. 12!95
Tl, 73 ~y-/s-~,
s
~.
i
N
~;<<s~.
t~~~
~ ~ie/~ ~ r~
7~/~~/2
/!~1 5~~~~~~c~ ~~
1~--/
0
Edward Buchardt
2231 Hollow Road
Blair, NE 68008
July 10, 1996
RE: Construction of new home on Tax Lot 73, S14-T18-R11
Dear Mr. Buchardt,
On June 10, 1996, a final inspection was made at the above
location and failed. An inspection slip was left at the location
detailing the items that did not pass inspection.
It is your responsibility to correct these code violations and
contact our office as soon as possible for a reinspection of the
property. We are unable to return the building permit deposit to
you until the final inspection been approved.
If you have any questions, feel free to contact this office.
Thank you for your cooperation in this matter.
Sincerely,
Brenda Taylor
Administrative Assistant
City of Blair
218 South 16th
Blair, Nebraska 68008
402-426-4191
Fax - 402-426-4195
~~,
EOUAI NOUSINO
OPPORTUNITY
~' promise
~a~,~
m~~~
/~ r~~
~~2 ~~~
ATTACHMENT C.
SOIL ABSORPTION TEST DATA REPORT
PROPERTY WHERE SOIL. TESTED: Owner: ~' ~!.~lL/-/~~ I
Location: Township ~~1~G~-~
Section ~ 1/4 Sect. Address:
Property Dioensions: ft. x ft
Area: _ acres. (Attach sketch of property showing hole location).
Soil Type: Silty Clay _:-Silty Clay Loam Sandy Loam _,
Silty Loam _: Clay Loam _,: Sandy Clay
Oates of Tests • 4~-/~ ~~~ to ~-/~~ ~~ Weather : Preci p . c~~1 Temo . Z_
= PE RCOLATION. TEST DATA FILE
a. b. c. d. e. f. h. i. k. 1. m. ~ n.
Pre-Saturat ion Period Percolation Re adin s Results
Sta rt E nd St art End Elaps- Water
Hole
No. Hole
Depth
in. Oate
(Mo.
Da Time
(Hr.
.Min. Date
(Mo.
Oa Time
(Hr.
Min. Date
(Mo.
Da Time
(Hr.
Min. Water
Level
in. Time
(Hr.
Min. Water
Level
in. ed
Time
Min. Level
Drcp
in. Percolat'.
Rates
Min. itx
~~ cr i'b.UO ,~ ~
" i~ 3/ /D,90
b=c9v c~ /D'~n ~~j ct off. ~ /3,
3a c c /l 'o~ r i ~ /5
~'oo ~c 1: 3o Li 9
oZ, /s
c c o2.'da ~ s _
3 D E! ~ 3/~ ~ t % (~
J^J^N, V^ rc~a.v ~o~~.+^^ ~w ~c.a
Average of Rates: ~S,oB
S~ nature of Person Conducting test Inches per Minute:
Address 753 ~ f~~ ~C~~ ~~'
Phone ~1~~-36 77
,~
i
AT7ACHI'~ENT C- ~~
SOIL .ABSORPTION TEST OATH REPORT -
Owner : J Q ~ ~/~ _
ROPERTY WHERE SOIL TESTED=
Location: TaMnship . ~~'~,P•',
Section ~ i!4 Sect- ~r~' - ,
Property 0inensionsz _____ ft. x ~ ~ ~..
acres: (A sketch of property showing hole location): }
.~~ :Silty Clay Loam _: Sandy Loans
Soil Type. Silty Clay _ ~ ~:
Silty Loam _: Clay Loaar +: Sandy Clay _ ~
.. q to ~.. //-~( Weatfier: Precip. ~ Tejo.
)ates of Tests: °/~ ~ -_ ..
.., ~ .
~~ -~' ~
Pre-5aturat~on ~~ ~~~ Start End Elaps- Water
Hole St rt End
Oate Time Oate Tice
Oate Time
Hater
l
lime
(H
Water
Level
ed
Time
Level
Drop
le Oepth (Mo. (Hr. (Mo. (Hr. (Mo- (Hr.
Min Leve
in r.
Min. in- Min. in_
in. Min. Da Min.
Oa .
-/I v .
~ ' ~" •U ! ~~ dam"
~~
~~ ~ ~ ~ ~ p~ p c~ ~ r
1 ~ a QC7 L(
l(
( c ~ '`
~f ~~ d f
/ C~
p t
c~ a%uo .
~~
~ c1
~~bo er °~p 4l
2 (~ ~~
~
~ `'gin c l /.`a 6 3/Q ~ ~
nature of Person Conducfiny Test
Address ~s3 ~ .l~ ~ '$~~' `~~
Phone ~~ D
Sum of Percolation
Average of Rates:
Incfies per Minute:
Percolat"s
Rates
~~ ~
• i
ATTACHMENT C.
SOIL A650RPTION TEST OATH REPORT
PROPERTY WHERE SOIL TESTI~~~ Owner: C!~ ,~wClCu~lc,r1~
Location: Township
Section do 1/4 Sect. Address:
Property Dioensions: ft. x ft
Area: _ acres. (Attach sketch of property showing hole location).
Soil Type: Silty Clay _: Silty Clay Loam Sandy loam
Silty Loam _: Clay Loam :Sandy Clay
Dates of Tests: ~!d ~9(A to 4~-~`-9fP .Weather: Precip. ~I~i Temo. `7~
ncnrne wTTnu TCGT 11ATA DTI ~
Pre-Saturation Period Percolation Readin s Results
Sta rt E nd St rt End Elaps- Water
Hole
No.
- .Hole
Oepth
in.
~~ Oate
(Mo.
Da
-l0 Time
(Hr.
Min. Date
(Mo.
Oa
0 Time Date
(Hr. (Mo.
Min. Oa
X1:00 -!! Time
(Hr.
Min.
'~:UO
g~3o Water
Level
in.
`~
~~ Time
(Hr.
Min.
.`-3.Q
D:Qo Water
Level
in.
l~
3~a.. ed
Time
Min.
OvLt
a Level
Drop
in.
3 ~
.~
y Percolat'.
Rates
Min. ant
/~!-
~
o:ao , ~~ X30 3 ~ Lc 1
a /
.
o` ~ ~c /~o0 3 ~ << ~ / .
libr7 e! !'' b ~ ~ 1 ~
O d t I ~ a ~/~, i 1 a2
Sum of Percola tion R ates i/~ SR
~~ Average of Rates: a.
Signature of Persan Conducting Test Inches per Minute:
Address ~j 3 ~ ~~~ ~~~~~- ~~
Phone - ~~ ~ ' 3 ~~~
~~ ,~/1~1~CS. Eli ~UCd: E~OL~(G~' ~~C BEST
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