Signature Page11+1 U1311�-
A $500.00 refundable 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.
$50.00 efundable 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
Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
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.
Deposit will be applied to water account # 10055002/
Contractor/Owner Contractor/Owner
LL
Date
City of Blair
Cl�,'-DFBU)IR
20SMTH ST
KAIR NE 6803
_______ ________
D
MAM3-�O8
HOLZER LARRY X. WAN8A
636 N 1OTH AVE DECK RPLOR
PERMIT PAYMENT | 217.001,
ACCOUNT 8AL .00
�I R—ce.ivedi 217.00
--------------- ____________
Address
Permit # d k 17 R o
New Construction Checkoff List �fILE COPY
Date Received Initials Date Approved
1) Building Plans
2) Site Plan
3) ResCheck
4) Water/Sewer Connection Fees
(Additional fees apply)
5) Given to Zoning 9 -
6) Zoning Approved
7) Site Plan Approved
8) Flood Plan Checked
9) Storm Water Management Report
10) Given to Building Inspectors