BP6751BUILDING PERIIIIIT APPL CATI®N ~~~xi
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permits ~ ~ I
Application Date: ~ ' ~~ J ~ Issue Date: ~7" ~~ "~~~ Permit Fee: $ ~~I~+ •~°°r
JOB ADDRESS
_ / ~
V ~v I
LEGAL
1' DESCR. LOT NO. ~ BLK. TRACT ~I,I ,
/VUI~~~~
^ SEEATTACHEDSHEET
2. OWNER MAIL ADDRESS
i ~l._ C'o~'~ v~~-ra ZIP PHONE
CONTRACTOR .'~~~
3. ~ c~UC~r~ n AILADD~ ~ ~~~ ~
; ~ J r 1 P~~l/~/r l~~ ~ LICENSE OC~
C~-ll~7 Z4~
USE OF BUILDING
4.
5. Class of Work: ~] NEW ^ ADDITION ^ALTERATION ^ REPAY ^ REMOVE
6. Describe Work: ,
7. Sq. Footage of Structure pnduaing BBSementana GarBgs): ~(~,E ~ ~. C`~ ~~ ~~ , ~
8, Change of Use From: Change of Use
g, Valuation of Work: $ l ~ C°L~j_ ~`~ ~
10. Floodplain: Floodway Yes^
Fringe Yes^ No ^ Dev. Permit
No ^ BFE ev. Cert.
11. Current Zoning:
12. State Fire Marshall Required: Yes ^ No[~'
13. Special Use Permit Required: Yes ^ No [~
14. Variance Required: Yes ^ A No [.~ ,Z ~
15. Minimum Setbacks: Front ~ Side ~_ Ream
16. Sidewalk Required: Yes No ^ Waiver Approved
APPLI ~ ATI~N /1CCEPTED BY I PLANS CHECKED BY I A~ VE 0 ~ }JANt~~ I
~ NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi•
tinning, and septic systems. By 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 this application form signed by the Building Inspectorand stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the specifications setforth
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,
is not completed within 2 years of the date of issuance, or if work is abandoned for six (8)
r~oAths or longer, whichever is earliest.
OF l7WNER/CONTRACTOR,Qr# AUT,liORIZED AGENT
OWNER (IF OWNER
DATE
Site Plan Attached ^ Complete PI Attache `~
Approximate Completion Date ~ ~~/~~
Inspections Required and Fees
~ Utilities ~
Sewer Tap - ~/tTT ater Tap .
Sewer ~~l .eater Service ~ = ~
Septic Remote
~ Building
.2S Y~
c~
Footings lt, . Drywall
/ (before finish)
n.l _
Framing `~ Final ~ _2 ~ ~
~~
_ Electrical ~
Rough-in ~~ ~-~"' Permanent Service
Final t ~ ACS Temporary Service
~ /~ Mechanical
Rough-in `/L'-G=~~-;~~A~C ~~~~~
Final ..~
~ umb. ing .
Ground Work ~ ~~---
Rough-in f Final ---
WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT
Comment: ~~d~c~ Approved By;
POUNDS PRTG: Blelr, NE Rev. OB/85
BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
~~~7
Application Date: I ~-~~'~ ~ Issue Date: I I-I ~' {~-S Permit Fee: $ 1 Z ~(~
JOB ADDRESS
~ `~5 ~ i4c~ o~m
LEGAL
1 ' DESCR. LOT NO.
--~ BLK. TRACT -
,~`~~~~ 7
V ~./
^ SEEATTACHEDBHEET
2, OWNER ~ ~r1 /'lJ + ~I ~~C.`' MAI/ ~nDDRESS
~~~~~ ~
v '
,
L r
- ZIP PHONE
I
DD
RESS
A~A
CONTRACTQ ~
3. `jai LK. ~ ~~~C`I-~~C:. ~ 0 , ~~~x PHONE
~ ~~ ~~~ar r`- LICENSE NO.
~f~?l~- y~~~
USE OF BUILDING
4.
5. Class of Work: [~ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: }-~~~~ ~~C~-~~~
7. Sq. FOOtage Of StrUCtUrB (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
10 Floodplain: Floodway Yes ^ No ^ Dev. Permit
Fringe Yes^ 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 ^
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes ^ No ^ Waiver Approved _
APP~I~L~ Q~ T~ BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
~ NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By 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 unti- I
have received a copy of this application form signed by the Building Inspectorand stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the specifications setforth
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,
is not completed within 2 years of the date of issuance, or if work is abandoned for six (8)
months or longer, whichever is earliest.
OF OWNERICONTRA~TOR OR AUTHORIZED AGENT DATE
Sewer
Septic
CATION
Permit
Water Service
Remote
Building
Footings Drywall -
(before finish)
Framing Final -
/ Electrical
Rough-in (~~ C-~ Permanent Service
Final ~' ~ ~~ Temporary Service
Mechanical
Rough-in ABC _
Final
Plumbing
~O-~~ Ground Work
GNATURE OF OWNER (IF OWNER BUILDER) DATE ROUgh-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRT(3: BIeV, NE l / Rev. OalBS
BUILDING PERMIT APPLICATION
' Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 (~ `~~ Q. 9
(402) 426-4191 Permit
/~ ~ 9 /sue ° `~
Application Date: f ` ""h Issue Date: / t Permit Fee: $
JOB ADDRESS ~ f~
~~ ~ ~ Gil / / ~~
1. LEGAL
DE CR. LOT NO. ~j
~ BLK. TRACT r r \
(~~ ^
SEE ATTACHEDSHEET
2. OWN MAILADDRESS ,- ZIP _~~1Ej'P ~~
3 CO R R DRESS ~ / L~ PHONE
~> ~ o ~ ~~j>'l- ENSE N
l~
4. USE OF BUILDIN
5. Class of Work: ^ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work:
]. Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodwey Yes ^ No ^ Dev. Permit
10 Floodplain:
Fringe Yes^ No ^ BFE
Elev. cart.
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 _
APPLICATION ACCEPTE9 BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I acknowledge that payment of the
building permit application fee does not constitute issuance of this building permit. I further
agree lhat construction covered by this permit application shall not be commenced until I
have received a copy of this applicaiion form signed by the Building Inspectorand 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
Nebr ka. I understand that this permit is void if work is not commenced within 160 days,
is n ompleted it ' 2 ears of the date of issuance, or if work is abandoned for six (6)
,mots r longe w ' is arli t.
SI TURE OF OWNERICONTRACTO AUTHORIZED AGENT DATEOF OWNERJCONTRACTO AUTHORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
--~~
Sewer Tap ~~ Utilities
Water Tap
d
Sewer lO ~
Water Service /~ ~ ~
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in
Final
Permanent Service
Temporary Service
~ a Mechanical ~~ ~ ~~
Rough-in ABC
Final
Plumbing
Ground Work ~ o c~
Rough-in /~ ~' Final
WHEN PROPERLY VALIDATED (IN THIS SP~4CE),T-kI~S IS YOUR PERMIT
Comment:
Approved By:
POUNDS PRTG: Blelr, NE Rev. eel85
CITY OF BLAIR
Application for Building Permit
PLOT PLAN
h'
4
N
fi
.,
v
Address Date ~ o~p ~ ~ ~
Legal Description: Lot ~ Block Addition O `~x~
Please show all measurements of existing and contemplated structures,
also show distances between structures, etc.., and property lines.
Is this a corner lot?
'~ Pro ert Line
Y '
~o
~,
,~
a .
~_
_
7
~~~
a
0
w ,~
~ N
3.0
S
~ndicate~ North
~`~. - .
_ _Center Line_of _ _ ~ ~ ~ Street_ _
Applicant,
o,^
Nielsen Construction
1616 Adams Street
Blair, NE 68008
Dear Jim,
City of Blair
218 South 1 bth
Blair, Nebraska 68008
402-426-4191
Fax - 402-426-4195
January 6, 1997
Enclosed please find a building permit refund for permit #7138
for a remodeling project for Tim Ott.
Also on January 6, 1997, Dale did a final inspection on the
residence located at 1024 Flynn Drive. This final failed due to
several code violations which were noted on the inspection slip and
left at the residence. Please correct these items and contact our
office for a reinspection no later than January 31, 1997.
As a reminder, building permit #6751 for a residence at 1357
Adams remains incomplete as you have not yet returned the agreement
which was sent to you on November 15, 1996. I have enclosed
another agreement in which you will need to sign and return no
later than January 17, 1997 or we will need to terminate occupancy
at 1357 Adams Street and require the egress window be installed.
If you have any questions, feel free to contact me. Thank you
for your prompt attention and cooperation in this matter.
Sincerely,
~`~'
~°
~ ~.
0
~ promise
Brenda Taylor
Administrative Assistant
EQUAL H W SING
OPPORTUNRY
~ ~,
4~^
.. o~ ~J
~9 promise
Nielsen Construction
1516 Adams St.
Blair, NE 63008
Dear ~7im,
City of Blair
218 South 1 bth
Blair, Nebraska 68008
402-426-4191
Fax - 402-426-4195
November 1_5, 1996
Enclosed is the agreement we spoke about a week or so ago
regarding the egress access in the basement of the residence
constructed at 1357 Adams Street.
Please sign at the bottom and return to me along with a $10.00
filing fee as this document will be filed at the County Clerk's
office. Also, your signature will need to be notarized, which I
can do if needed. Once this form is filed, I will send you a copy
for your files and finalize your building permit returning your
5200.00 deposit.
If you have any questions, feel free to contact me. Thank you
for your assistance in this matter.
Sincerely,
Enc
Brenda Taylor
Administrative Assistant
EQUAL N W SING
OPPORTUNRY
AGREEMENT
This agreement and representation is made this day of
199 6 by the undersigned to and on behalf of the
City of Blair, Nebraska, to-wit:
Whereas, the undersigned are all of the owners of the
following described real estate, to-wit:
LUT 3, NURTHVIEUI GIASHINGTUN CUUNTy
and,
Whereas, the undersigned 'nave applied for a building rArmi * to
rui ~ d a new ho~.tsP wi t_h_ basement ; and,
~ Ye the building code has changed FrOpi '-ha ti;np ~a r*ni t
~he_ as,
WaS_SS?led rac~ui ri ng 3 agr?SS from the basements, and,.
Whereas, the undersigned warrant ar_d represent to the City of
313ir that no part of the basement will be occupied.
NOW; THEREFORE, the undersigned hereby agreA as follows:
That the undersigned spec', r, cally YepreseP.ts and warrants
to the City of 31air that no portion of the basement of the
residence lpcated on the above described premises will be occupied
Sri pr tp the COP_Str,lrrti pn pt a egress access that meets the Ci*'y of
Blair building code.
?. 'T'hat the egress access shall not be constructed without
a permit and inspections prom the Ci t-~ of Blair.
3. This agreement shall run with the land and shall be
binding upon all successors and assignees of the undersigned, and
that all future owners of the above described real estate shall be
specifically bound by the terms and conditions hereof and that no
portion of said basement may be occupied until said ingress and
egress have been constructed.
This agreement shall be binding upon the heirs, personal
representatives, successors, and assigns of all parties hereto.
STATE OF NEBRASKA )
ss
WASHINGTON COUNTY )
being first duly sworn and
upon oath, depose and state that he/she/they have read the
foregoing Agreement, know the contents thereof, and that the
statements therein contained are true as he/she/they verily
believe.
Subscribed and sworn to before me this day of
199
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