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BPP19961125PLUMBING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Application Date: /~oZS~_~`i Permit Fee: $ ~~ r~ JOB ADDRESS .~ ~~ ~J / A ~ 7~/ld~ , 1 . LEGAL DESCR. LOT N0. BLK. TRACT O SEE ATTACHED SHEET 2. OWNER MAIL ADDRESS ~t~e-o~2J ~~fJr~ / ZIP /l/l~. ,~.~~t PHONE ,3. CO OR MAIL ADDRESS PHONE ? 95~d ~ LICENSE N0. U o 4• Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS REPLACEMENTS 5• Describe Work: ~~~ ~~%,~,~ ~Z Comments: PLUMBING PERMIT FEES ~ ~) ^ Type of Fixture No. ~ I r ~/ Kitchen . Bath ....................................... $8.00 x $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 ~ ~~, ©~9 NOTICE Sewer .................................... ~ $10.00 ^ '~ I 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 overnin this ty e of g g p ........ 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 f `~' 0O SIGNATURE 0 CONTRALTO OR THORIZED AGENT a~ ~ ~~ TOTAL r ~'c c ~P ~~ o~ ~l DATE Current License on File OYes O No O NA WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: . P i ~ POUNDS PRTG Blair, NE Rev. 72/95 ? ~ r a y r' ~ d o o ~ d b 3 y o ' z ~ ~ d m ° t~ m n n ~' 0 ~ 0 .r, m r 0 ° b ~' o d m z ~ a r r ° ro b d ~'' o zz~ z \ .. n ~ ~ ~ ~~ ~ ^ ~ ~ ~ ^ 0 0 r D z r O r ~ ° ~ ~ ~ ~ ° `j ~ ~ ~ 1` y O a ~~.y l J z x ~ ~ ~ ~ ~ r o ~' y o z ~ ~ ' ~ vi ~ O ~ ^-~ ~ ~ b ~ O Ci7 ~ z m ~ ~ ~ ~ ~ ~ ~ z p ~ r ~ b ~ x ~ ° ~ r ~ ° ~ z o ^ •t ~ ^ . ~ a ~ a ^ ~ ^ ~ ° ~ o ~° ~ ~ d b z ~ b z r~ Li J ~ ~ ~ m ~ ay ° a _ ~ ~ `~ ~ ~ ~ o ° o z ~ ~~F. ~ ° ~' ~ , ~ ~ ~ . r , z z ~ b ~ ~ r ~ ~ ~ O ^ ~ ~ 1 '~ z . , ~ ~ ~ ~ J~ ° '~ ~ O ~ ~ ~ z ~ ., ~ o ~ ~ ~ ~ ; , t I ~. o y ~ - ~ i :_ ,_ . _, i, o ~ ^ r ^ ~ ^ ^ r ^ ^ ~ ^ ~ ~ a o ~ ~ ~ z z ~~b ~ ^ ~ ^ ^ o En ~ ~, ~ ° ~ ~ ~ ~ ~ ~ ~ 4° ~ Z • ~I 1 ~ O ~ ~ ~ b ~ 1 z ~ ~ ~ ~`~ ~ z K 11 ~ ~~ ~ m o ~ ~ ~ ~ ~i o ~ ^ ~, x r ~, ~ n h~ o i z ~~~ ~ ~ ~ ~ ~~~ "~ Z O ~~~ ~ ~ o ~ ~ ~ ~ ,: , '~ f { j, , 5~5~~, ~ ~~ ~ ~; y `~ 1 ~~~