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P0101The City of Blair Building Permit Detail Permit #: 0101 Issued: 10/09/1998 Completed: 10/13/1998 Owner: Roland Rasmussen Address: 11578 Co Rd 27 Blair, NE 68008 Type: Plumbing Miscellaneous Valuation: Permit Fee: $10.00 Issue Fee: $15.00 Deposit Amt.: Receipt #: Phone: Section: Township: Subdivision: replace laterals Inspections Date By 10/13/1998 KAR Range: Lot: Septic -Laterals & Drainfields Block: Pass Remarks Contractors Henton Trenching, Inc. General Contractor Permit # Issued ll Jurisd Application Date: ~ (~ ~" ~ '~~ fiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 (402) 426-4191 x ~` Permit Fee: $ -~`' 4• Describe Work: Comments: ~ LUNi81NG PERMIT FEES Modular Home ...................... $15.00 Type of Fixture No. Kitchen .................................. $8.00 x Bath ................................... .... $8.00 x Rough-In Bath ................... ....$4.00 x Slop Sink/Laundry Tray ..... .... $5.00 x Water Heater ..................... .... $3.00 x Outside Water Faucet ....... .... $3.00 x Drinking Fountain .............. .... $3.00 x Water Service .................,,.. ....$10.00 N®TIC 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 governing this type of Septic T-~ Laterals ...... ....$10.00 ~ . work will be complied with whether specified herein or not. Lawn Sprinkler System ..... .... $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 Sprinkler System ............... .... $30.00 law regulating construction or the performance of (Commercial) construction. Gas/VVater Piping System (Commercial) ....................... ..... $30.00 ~ ~, f" Permit Issuance Fee ............. $15.00 ~ ~. ~a ~' ~~' SIGNATURE 0 CONTRACTOR OR AUTHORIZED AGENT r~ ~ r i DATE Current License on File Yes O No ®NA WHEN PROPERLY VALIDATED (IN THIS SPACE) ~~HIS IS YO~1R PERMIT ~, Comment: Approved By: ~ ,, ,a- , POUNDS PRTG: Blair, NE '~`° "''-' '~ ~ Rev. 4/98 __ ~ i _- ---.-- -- _~ ® ~° I INS CI T _ - ,'~: i - f [I_~ CITY OF BLAIR [] WASHINGTON COUNTY ^ 0'~g2 '~LOCATIONOFINSPECTION: . ~, ~) ~ :' ~ `~ ,~..4;~ NAME OF 0 ~ ` -' -°°. WNER: ~ ' f _ ~~~""' ° ~ e(~1~''I'RACTOR: ~f ~f _~ 3- -~ ~->-~ ,.~y ' ,~ ~ - >' DATE INSPECTION REQUESTED `"f `` F r,~` ,h ~ ~ t 1 _- ` ~-' ,' '~ ' PERMIT N0: ~ . TTMEINSPECTIONREQUESTED: ~ c~ j `~ 1 TYPE OF INSPECTION REQUESTED: I BUILDING: g ~ J-FOOTII~IG ^ FRAMING [] DRYWALL ^ FINAL UTILITIES: ~ ; ~i,' .~ ~~ ^ SEWER TAP ^ SEWER SEPTIC f ' ~ $ ` " ~ ~~~ I ,. ^ ~]-WATER TAP ' ~ ~ f f , ,,r I I ^ REMOTE ^ WATER SERVICE f ELECTRICAL: ~ - ~ []ROUGHIN []-FIXTURES ^FINAL ~ ~, ^ MOTORS I ~` ' ' ~ PERMANENT SERVICE [] TEMPORARY SERVICE ...i' MECHANICAL: I I E~ - ^ ROUGH-IN ^ A[C ^.FWAL 1 ~ i ~ ~ PLUMBING. ~ ^ GROUNDWORK ^ ROUGH-I ~r~, ~ !~ RESULTS OF THE INSPECTIO SSED Is~~ro~s) ^FAILED (s~ivoTES) ~-, r- NOTES/REMARKS: ~, , _~ ~ WSPEC ~, - E: j . DATE OF INSPECTION MADE' -TIME: ~~ , 9 f . CALLED OPPD\ TO CONNECT SERVICE: Q YES ~ NO .~ ~ -' ~ ~ ~ ~ WANT OFFICE STAFF TO CALL OPPD\ ~_ . ~ ~ `------ - ^ YES ^NO BLR 1 s `~~.`~ ~~~~ ~ ~l ~ J ~~ v E~~y ~~~ , ,a^ ~ ' 6 1 ey [ ~, V R ~ '~ ~ , ^ ~,l ~ t ~~ ~° 1 ~ry "f ~, ~~ ' `~. ,~ ~., =~