Signature PageA �50000refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. permits.
The City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
I1 Theft of water service by the plumber, owner, or general contractor.
2 All permits have not been obtained.
All required inspections have not been obtained.
Occupancy occurs prior to a final inspection.
The project is completed without a final inspection being done.
W-9 is not filled out for return of deposit
Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
I hereby agree to the above conditions and understand that should any or all
of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discretion of the City of Blair, Building and Inspections
Department.
Contractor/Owner Contractor/Owner
�z
Date
City of Blair
CITY OF BLAIF
218S16TH ST
_________________-
--- Amount
Ation
~----_____________-
,
Permit
RUCTI
G PRMT
CK#1236 330ST NUB
Q S 3!V 2�1OJ0
PERMIT ,
2�1
CHCJ0K Received ' -
^�
____________________
Address -33o S, �;-� Sl-
Pennit # C /\) - doh) — 0 6031
New Construction Checkoff List
Date Received Initials
1) Building Plans --7
2) Site Plan
3) 40�heck
4) Water/Sewer Connection Fees
(Additional fees apply)
5) Given to Zoning -7-
6) Zoning Approved
7) Site Plan Approved
8) Flood Plan Checked
9) Given to Building Inspector
ti
Q'I
Date Approved