P19960529Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
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Application Date:
~'`~
Permit Fee: $
Comments:
PLUMEING PERMIT FEES
~~
~ Type of Fixture No.
Kitchen .................................. $8.00 x
~' Bath ....................................... $8.00 x
~~ Rough-In Bath ....................... $4.00 x
i.,>~ Utility ..................................... $5.00 x
Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
Water Service ........................ $10.00
~,~
Sewer $10.00 ~_ / ~ '°
NOTICE ....................................
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 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
law regulating construction or the performance of Sprinkler System ...................$30.00
construction. (Commercial)
,~ ,;~ Permit Issuance Fee ............. $15.00
SIGNATURE OF CONTR TOR OR AU 0 E AG T ~ ~!J
q ~ ,,,~~ T®~T/4L
°ATE ~/~ ~ Current License on File ~ s O No O NA
wrltN NHUt'tHLY VALIDATED (IN THIS SP CE IS YOUR PERMIT
Comment: Approved By:
2- ~~ c .
rwnus rrt w: tsiav, NE Rev. 12/95
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°';' CI`I'I' OF BLAIR ~ WASHINGTON COUNTY ~ O'~~,j
' LOCATION OF INSAECTIO ~~ ~ ,~
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NAME OF OWNER: ~'~'-~ 1~, .~'t CQNTRACTOR: ~ L
-DATE INSPECTION REQUESTED: d d~~-~pERMIT NOs
TIME INSPECTION REQUESTED: (.~ ~ ~ , F (~ C} ,
r TYPE OF INSPECTION REQUESTED:
~_ , BUILDING: - -
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I
^ FOOTING ^ FRAMING
~.. ^ DRYWALL ^ FINAL
UTILITIES: '
^ SEWER TAP ~ S
E'ER
r;
^ SEPTIC ^ WATER TAP
Q REMOTE ; ~ ~ ^ WATER SERVICE
'[ ~ ELECTRICAL:
f ~~
~
( Q ROUGH IN ^ FIXTURES ~ FINAL ~ MOTORS
I
PERMANENT SERVICE
~_:; 3
(] TEMPORARY SERVICE
MECHANICALs a
~
~:.
^ ROUGH-IN ^ A/C
^ FINAL
PLUMBING: