BP7156,~
BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date: ~- /~ wq~.
Site Plan Attached ^ Complete.Plans Attache
Approximate Completion Date j
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer
JOB ADDRESS
LEGAL
1 LOT NO. ~ BLK. TRACT
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^ SEEATTACHEDSHEET
' DESCR.
2. OWNER MAI ADDRESS ZIP ~,1~ ONE
3 CONTRACTOR y / 7 ~ ~ DDRESS
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4.
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5. Class of W ^ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work:
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,
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], Sq. FOOtag@ Of StrUCtUre (Including Basement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodway Yes^ No ^ Dev.Permit
1p
Flood
lain:
EIev
Cert
.
p
Fringe Yes^ No ^ BFE .
.
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 ACCEPTED 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 tee 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 copyof this application form signed bythe 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 Ciiy of Blair and the State of
Nebraska. I understand that this permit is void if work is not commenced within 180 days,
is not completQd wit in 2 years of the date of issuance, or if work is abandoned for six (8)
.. --,v~~
OR AUTHORIZED AGENT DATE
CATION
Permit ~ ~" ~ 6
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Permit Fee: $ ,~a '~'
Water Service
Septic Remote
Building
Footings
Framing
Drywall
(before finish)
Final ~ U -~~ ' ~~
Electrical
Rough-in Permanent Service
Final Temporary Service
Mechanical
Rough-in ABC
Final
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in _
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
Issue Date: ~D' ~ ~" 9(a
Plumbing
POUNDS PRTO: elalr, NE RBY. OeleS
NOT FOR CONSTRUCTION
THE WORK 1LLU~~RATED HEREON DOES NOT CONSTITUTE A
BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES
THAT A BOUNDARY SURVEY MAY DISCLOSE. IF A BOUNDARY
SURVEY WITH LOT CORNERS LOCATED AND MARKED IS
REQUESTED, THEN ADDRIONAL CHARGES WILL ACCRUE.
DATE: 12/28/95
FOR: CHERI AND SCOTT STANLEY
PLOT~~
PLAN
621 NORTH 10TH AVENUE, BLAIR, NE
THIS IS A REPORT OF AN INSPECTION MADE FOR LOAN PURPOSES AND TITLE INSPECTION PURPOSES ONLY AND SHOWS IMPROVEMENTS ON
LOT 7, GREENBRIAR; AN ADDITION TO THE CITY OF BLAIR
AS SURVEYED, PLATTED AND RECORDED IN WASHINGTON
couNTY, NE
_ - - -~UNEAR A:dD A?dam ULAR 14 R! JES SHO'Nt+t ARE BASED•ON RECOROOP DZ=F.~INFG~iMATiOh). -
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--- : ,,
~ f,; P.BUILDING: INSPECTION REPORT ~
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[~CTTY OF BLAIIt : ~ WASHINGTON COUNTY . ~ 0'~ER
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LOC:ATION_OFINSPECTION _ ~ ~ ~ ?~iJ , ~C4'~~? y~-J /J`~
NAME OF OWNER:._ .~ :' ~~`~l`J ~t°t;~ ` ~ ~f ~ ~
CONTRACTOR: _ (L~ 1 r~i ~+' rt/ ~-~~c~_
DATE WSPECTIONREQUESTIrD:_--~(~r~~ ~~. pERMITNO: ~~~ ~,~r
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TIME INSPECTION REQUESTED: ~, ( { i
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E
TYPE OF_INSPECTION REQUESTED:
BUILDING.: ~ 1
[ ^ FOOTING ~ FRAMING D DRYWALL ~i FINAL ~~~~ ~n I
UTILITLES: ~ ~~'' ~~~ ~ ~ .
~~
~, ^ SEWER TAP ^ SEWER
^ SEPTIC ~ WATER TAP
1
~- ,.~
^ REMOTE ^ WATER SERVICE
~ _. I
i
'ELECTRICAL:
,: i
^ ROUGH W. . ^•FIXTURES Q FINAL Q MOTORS
Q-PERMANENT SERVICE Q TEMPORARY SERVICE
MECHANICAL: ~
. _ j,
^ ROUGH-IN ~ A/C I
^ FINAL ~ I
~; , .,PLUMBING;
L -_ ^ GROUND-WORK ---,- --- - -- - ----: _ -~--- ~ -------
F ROUGH-IN----Q-~~----- ---- ------
~ i
RESULTS OF THE INSPECTION: 'PASSED ~s~xoTESi ^FAILED ~s~rro~s~
NOTES/REMARKS: .
:t ~ I
F,..
/.
DATE OF WSPECTION
TIME:.. ~ ~r~~
-CALLED-0PPD\ TO CONNECT SERVICE:. YES ^NO
WANT OFFICE STAFF TO CALL OPPD\
::: , -_ ^ Y~__ LINO BLR<i