BPP19960718PLUMB
A lication Date: ~ ~~
PP
n
CATI O N
Permit Fee: $ ~"~
JOB ADDRESS ,
LEGAL
1 • DESCR. LOT N0. BLK. TRACT
O SEE ATTACHED SHEET
2. OWNE _ MAILADDRESS ZIP PHONE
3. CO RA OR MAIL ADDRESS ~ ~ ~ PHONE * LICENSE N0.
4. Class of Work: O NEW RESIDENTIAL ONE OMMERCIAL O REMODELING/ADDITIONS O REPLACEMENTS
b. Describe Work:
Comments:
PLUMBING PERMIT FEES
n ~1~~
1
~
\
Type of Fixture
Kitchen
No.
$8
00 x
. f~~
~\ ' ..................................
Bath ....................................... .
$8.00 x
Rough-In Bath ....................... $4.00 x
Utility ..................................... $5.00 x
Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
Water Service ........................
$10.00 a~
NOTICE Sewer .................................... $10.00
hereby certify that I have read and examined this Groundwork ........................... $10.00
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of Septic Tank & Laterals .......... $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.
/ ~
~ ®J
Permit Issuance Fee ............. $15.00 `
~..
GNATURE OF CONTR OR OR AUTHO IZED GENT
~G
TOTAL ~S
i
DATE Current License on File OYes O No O NA
WHEN PROPERLY VALIDATED (IN THIS SP
Comment:
ING PERMIT APPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Approved By:
IS YOUR PERMIT
POUNDS PRTG: Blair, NE Rev. 12195
^ ROUGH IN ~ FIXTURES ^ FINAL ^ MOTORS