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BP10117City of Blair Building Permit Detail Permit #: 10117 Issued: 3/2/2004 Completed: 9/20/2004 Location: 11281 Rambleridge Drive Owner: Donald and Ramona Norwood Address: 11146 South Street Blair, NE 68008 Phone: 426-3717 Permit Fee: 15 Issue Fee: 581 Deposit Amt.: Receipt #: Section: Township: Range: Subdivision: OAK PARK I Lot: 2 Block: 7 35 x 72 ranch modular home with 3 bedrooms, 2 bath, full unfinished walkout basement and 2-car garage under house. Lot size 132 x 155. Contractors SELF Henton Trenching, Inc. Judt Electric Plumbing Works, Inc. Remarks 9/20/2004 DEM Inspections Date 3/24/2004 4/7/2004 4/22/2004 4/22/2004 7/26/2004 7/26/2004 8/20/2004 8/20/2004 8/20/2004 8/25/2004 8/30/2004 8/30/2004 9/10/2004 9/16/2004 9/20/2004 9/20/2004 9/20/2004 9/20/2004 By DEM ItAR DEM DEM DEM DEM DEM DEM DEM DEM DEM DEM DEM DEM DEM DEM DEM DEM General Contractor Plumbing Subcontractor Electrical Subcontractor Plumbing Subcontractor Occupancy was Granted. Footings Plumbing Groundwork Septic -Laterals & Drainfields Water Service Electrical Temporary Service Electrical Temporary Service Plumbing Rough-ins Framing Electrical Rough-ins Drywall Footings Electrical Permanent Service Conference Status check Mechanical Final Final Inspection of Project Electrical Final Plumbing Final Type: Residential -New Construction Valuation: 126741 Permit # P1071 E1992 P1052 Pass Pass Pass Pass Pass Fail Pass Pass Pass Pass Pass Pass Pass Pass Pass Pass Pass Pass Issued 4/21 /2004 7/21 /2004 3/23/2004 BUILDING PERMIT APPLICATION ~~ Jurisdiction of City of Blair, Nebraska Permit Fee: (o.OD 218 South 16th Street Issuance Fee: ~ S=am Blair, Nebraska 68008 1 ~ 1 1 7 Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit Deposit Receipt #: ~ /~ ~ g~~ 1 Issue Date: 3! Z ~~"I Type: N ~ ~ ~es~ c~~-n~ JOB ADDRESS LEGAL 1 . DESCR. ~~ ~ ~1 ~C./~ ~ VCM ` ~G~,/~l` ~r~7 ~i ~ SEE ATTACHED SHEET ^ OWNER C ~~ MAIL ADDR`E'S/S ,/ ~, QQ Z,hP \ 2. RC~ma~(1G No~r~l oc~cl I I I ~-F(fl S~Ll1`+\ S~I• U ICll1~ INC HOME PHONE WORK/CELLPHONE ~~"~7~ CONTRACTOR MAIL ADDRESS 3. Sri' •'~ ZIP HOME PHONE WORKICELL PHONE MODEL 4. Class of Work: ~ NEW ^ ADDITION ^ RE UNFINISHED BASEMENT ^ OTHER ^ FINISHED BASEMENT / 5. Describe Work: ~ J ~7z rn~(.c~.r' ~OYnfL_ ~ ~.~1©~tt'~"1 S p y'GC,/l t~L~j7~f~715 'S~-~enf - ~.l K o~ - cap Cl~ ~c,~cr/ /!~u ~ _ f~ 13z X /,S'S" 6. Valuation of Work: $ ~~ ~C/~.®(~j Total Sq. Footage (IRCluding Ba6emeRtaRdGarage): ~Jpt.-~Q ~ Total Finished Area: ~ (~ . Floodway ^ Yes ^ No Dev. Permit 7. FIOOdplaln: Fringe Q Yes Q No BFE Elev. Cert. 8. Current Zoning; ~ L-- 9. State Fire Marshall Required: ^ Yes ~No 10. Special Use Permit Required: ^ Yes ~No 11. Variance Required: ^ Yes ~,No 12. Minimum Setbacks: Front .~, ~ Side ~~ Rear 13. Sidewalk Required: ^ Yes ~~ No Waiver Approved NOTICE Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic systems. By my signature below, I acknowledgethat payment of the building permit application fee does not constitute issuance of this building permit. I furtheragreethatconstructioncovered bythis permitapplicationshall not be commenced until I have received a copy ofthis application form signed bythe Building Inspector. 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 City of Blair and the State of Nebraska. I understand thatthis permit is void if work is not commenced within 180 days or is not completed within 2 years of date of issue. ,~ J~ ~~' SIGNATURE OF OWNERICONTRACTOR DA Comment: ~ ~D ~g~~.(~ ~St c (JGc ei1 _0 ~ ~~v ~ ~vv~ '~ ~~2 ~~~{ MEET IBC, IRC, IPC; IMC AND NEC C40E RECUIREMENTS SLEEPING' RaOMS~ BELOW THE FOURTH STORY AND IN BASEMENTS ARE. REQUIRED TO HAVE~AN EGRESS WINDOW.. POUNDS PRTG: Blair, NE ~te Plan Attached ~ om let tans ttached Approximate Completion Date -1- v l Inspections Required and'Fees Utilities I-I~P11`]da'1 Sewer Wate ice Ic R Sfop~Box Card Buildin Foo~' ~ p RIOR TO TAPING) Frami ~~ EI rical .~ i,c~~'~" ~-in R ~ gl Fi s ` ~,, ~ ~~°~ P ent Service porary Service ~ ~ " Mechanical ~Sc.~t./-~a R -in ~'1 ~~ Plumbing ~l~ ~ I° r d -'h~ ~blCt ( ~ Groyad~ork Rojq}yie~ ~iRat^ WHEN PROPERLY VAL~QTED~(aN THIS SPACE) THJ,S-I~fQ~PJR PERMIT Rev. 6/96 PLUMBING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 P 10 5 2 (402) 426-4191 Application Date: 3 ~~~lo`~ Permit Fee: $ JOB ADDRESS ~~ ~ ^1 ~~1~ L~ ~~ '~0.~ (C ~Y ~ GI C ~ 1 Y~ 1. OW MAIL ADDRE S Gr t0 Ct., ~ ~ pCC~ ~.,`~~ ZIP I ~(v ScSLb-l~ cS ~- ~~,1, PHONE - 3~1 ! -l CONTRACTOR MAIL ADDRESS 2 . PHONE LICENSE NO. . ~ ~ I orbs `I~°i8 N ,St• ~ e l•e NG ~~ro U 3• Class of Work: O COMMERCIAL ESIDENTIAL NEW O ADDITION O ALTERATION O REPAIR ~ REPLACEMENT 4• Describe Work: 1~rn~~ ~ ~ ~ ~~ '~ Comments: PLUMBING PERMIT FEES Modular Home ...................... $15.00 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 NOTICE Sewer .................................... $10.00 I hereby certify that I have read and examined this Groundwork ...........................$10.00 I ~~~~(1 e 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 Sprinkler System ................... $30.00 taw regulating construction or the performance of (Commercial) construction. Gas/Water Piping System (Commercial) ............................ $30.00 ~1~9.0 Permit Issuance Fee ............. $15.00 ~ 5~~ SI TURE OF CONTRACTOR OR AUTHORIZED AGENT 0 TOTAL - DATE Current License on File -0~(es O No O NA ,~ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment:. .~ ~ ~ •• ~ Approved By: POUNDS PRTG.~Blair, NE ~ Rev. M98 PLUMBINCa PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 1 O 7 .~ Fax (402) 426-4195 P (402) 426-4191 A lication Date: I OBI ~~ pp Permit Fee: $ ' JOB ADDRESS n 1 . OWNER I ` ~ ,~^ !, ~ /fir t~( AIL AD R SS ~~ ~ PHONE 1 (x MAI DR SS 2. CONTR C 0 n'~~~c~~ I PH NE S . ~~ LICENSE N0. ~ 3. Class of Work; O COMMERCIAL RESIDENTIAL NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT 4. Describe Work: ~ ~ ~ ~~ Comments: PLUMBING 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 ~^~ • w Water Service $10.00 NOTICE 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 S i T k & L l 1 ~ ( (~,` y' provisions of laws and ordinances governing this type of ept c an atera s .......... $ 0.00 b e 1.J 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 Sprinkler System ................... $30.00 law regulating construction or the performance of (Commercial) construction. / , ,~, ~ Gas/UVater Piping System (Commercial) ........................... $30.00 , ,_ _ , ._ "~~ Permit Issuance Fee ............. $15.00 SIGNATURE OF CONTRACJ-0 OR AUTHO IZED AGENT ~~- f/'- y TOTAL 6 DATE Current License on File OYes O No O NA WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: Pf111Nf1C PRTl-.Pla~r NF o.... •ioo ELECTRICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Permit E 19 9 2 Application Date: ~ ~a I~L"~ Permit Fee: J -~ JOB ADDRESS ~ ~ l ' , ' /WI Ivyh ~ /~ ~~ d~-~\ LEGAL E E ATTACHED SHEET 1 • DESCR. O S ( ~ 2 OWNER r 1 ~^ ~, D ~ 1 ~ f P ' ORK/COELL PHONE V "1 V- (~' ~ ~ ~~ ,3 CONTR OR MAILADDRESS ,// PHONE HOME PHONE L V WORK/CELL PHONE 4. Class of Work: NEW RESIDENTIAL p NEW COMMERCIAL ~ REMODELING/ADDITIONS O UPGRADE SERVICE 5. Describe Work: C'I ~~ ~ ~ ~~ 6. Current License on File Yes O No O NA Completion Date ~ New Service Fee = (Amp Fee + $2.00 per branch circuit) ELECTRICAL PERMIT FEES 1-100 Amp Fee ............................ $ 13.00 101-200 Amp Fee ............................ $ 18.00 Upgrade Existing Service ...... $10.00 ', l Temporary Service ................ $10.00 p W 201-300 Amp Fee ............................ $ 30.00 Fire Alarm System ...............•. $10.00 301-400 Amp Fee ............................ $ 42.00 Signs ............• ........................ $15.00 401-500 Amp Fee ............................ $ 55.00 501-600 Amp Fee ............................ $ 67.00 Miscellaneous Apparatus ...... $11.00 601-700 Amp Fee ............................ $ 80.00 AC/DC Circuit ........................ $5.00 701-800 Amp Fee ............................ $ 92.00 801-900 Am Fee $105,00 p ............................ Commercial/Multi-Family and All Upgrades: 901-1000 Amp ................................. $117.00 # of Circuits x $2.00 IF OVER 1000 Amp Amp Fee 1st 1000 Amp Fee ....................... $117.00 Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total New Residential: (Finished Area) NOTICE Single/Two Family Dwellings I hereby certify that I have read and examined this sq. ft. x .045 ~'~ application and know the same to be true and correct. All provisions of laws and ordinances governing this type of Modular/Manufactured Homes ....... $30.00 work will be c m li d ith h th ifi d h i t o p e w w e er spec e ere n or no . The granting of a permit does not presume to give authority Receptacle/Switch Outlets to violate or cancel the provisions of any other state or local Fixtures x $.75 law regulating construction or the performance of Smoke Detectors x $3.00 construction. Residential/Commercial Appliance # Fixed Outlets x $3.00 `~ / Motor(s) x $3.00 Power Apparatus (220 Volts) SI tSRE OF CONT A tOR OR AUTHORIZED AGENT # Apparatus x $3.00 ' (-~`1 Permit Issuance Fee ............. $15.00 DATE ~ TOTAL WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: 'OUNDS PRTG.-Blair, NE Rev. 11/95 - ~ BUILb~NG INSPECTION REPORT - :~. ^ CTAY OFjBLAIR ^ WASHINGTON COUNTY ^ OTHER LOCATION OF INSPECTI~O`N: f 1°~- NAME OF OWNER: 1 `~I ~1 ~ N C~L.~ r~ CONTRACTOR: DATE INSPECTION REQUESTED: ~~ ` ``-K-~' TIME INSPECTION REQUESTED: PERMIT N0: I ~~ ` TYPE OF INSPECTION REQUESTED: ^ CONFERENCE - ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED ^ ^ COMMENTS: UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ELECTRICAL: ^ ROUGH IN ^ PARTIAL ^ FINAL ^PERMANENT SERVICE TEMPORARY SERVICE ^ PRECONNECT PASSE FAILED ^ COMMENTS: MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED ^ ^ COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: I ~ lO l i ; i ~'0 CONNECT SERVICE: ON - BUILDING_.INSPECTION REPORT CI~'Y OF BLAIR LOCATION OF ^ WASHIN N COUNTY ~ ^ ~ ~f~ ~ ~ ~ ...~~ .. NAME OF OWNER• CONTRACTOR• DATE INSPECTION REQUESTED• ~ s ~ ~ TIME INSPECTION REQUESTED• `~ v U ~ PERMIT NO• ~ •~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASS FAILED ^ COMMENTS: UTH,TI'IES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT "` ^ FINAL ^ PARTIAL - PASSED FAILED ^ ^ COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED / ^ ^ ^ PRESSURE TEST COMMENTS: ^ `OCCUPANCY GRANT D ^ ONDITIONAL OCCUPANCY GRANTED /~~ ~~ TID~F• FAXED OPPD~BURT REA TO CONNECT SERVICE: ON ~ Y BUILDING INSPECTION REPORT CTTY QI~BLAIR ^ WASHWGTON COUNTY ^ OTHER LOCATION OF INSrECTION• NAME OF OWNER• ~ ~ ' CONTRACTOR • ~ °~'~-' """ '~ ~ " ° ~ ~' `~ ~ ~ ~ ~~ q~ , ~ 7 DATE INSPECTION REQUESTED: '1 ~ TIlvIE INSPECTION REQUESTED• y ~ ~J ~ PERMIT NO: ~ ~ ~ ` TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL , PASSED FAILED COMMENTS: UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED COMMENTS: PLUMBING: GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PED FAILED ^ ^ PRESSURE TEST COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS• INSPECTO DATE OF INSPECTION MADE: -v TTMF' ~~' ~O _ . FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY 0 ~rr~ ~pBLA~ ~,." LOCATION OF INSPECTION NAME OF DATE INSPECTION TIME INSPECTION REQUESTED• I ~ ~ PERMIT ~~U~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED ^ ^ COMMENTS: UTILITIES: ^ SEWER TAP ^ SEWER ^ `PARTIAL COMMENTS:_; BUILDING INSPECTION REPORT ^ WASHINGTON W ~,J SEPTIC ^ WATER TAP ^ REMOTE ~ WATER SERVICE FAILED. ^ ~,; ELECTRICAL: ^ ROUGH IN ^ .FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT ~ PASSED FAILED ^ PARTIAL ' ^ ^ COMMENTS: MECHANICAL: ^ ROUGH-IN '^ ,A1C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL , PASSED FAILED ^ PRESSURE TEST ~ ^ COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED ~1 FAXED OPPD~BURT REA L/l/ p.~L~~/ISATE OF INSPECTION MADE:- - TO CONNECT SERVICE: ON ^ OTHER ` TTMF.~ /~ ~ ~ ~V~ BUIL~~NG'INSPECT-ION REPORT O~_'aBLAIR ^ WASHINGTON COUNTY ^ OTHER LOCATION OF INSPECTION: ~ ;~ ~ ~ ~~ NAME OF OWNER: 1 ~ ~ CONTRACTOR: ~ V DATE INSPECTION REQUESTED: ~ ., ~ ~ TIME INSPECTION REQUESTED: ~ O ` ~ V G1 ~ PERMTI' N0: ~ " TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUII.DING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED ^ ^ COIvIMEN1'S' UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE®TE PO~Y SERVICE ^ PRECONNECT PASSED FAILED ^ PARTIAL ~~~~ 11 (/ /~ !/~~ ^ COMMENTS: ~'l V MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED ^ ^ COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED ^ ^. COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: L%ZT~ J _ a ~ _ _ ~_ TIME: Q~ I~ FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY ~. CITY~OF BLAIR LOCATION OF INS] NAME OF DATE INSPECTION REQUESTED• ~ ~Q TIME INSPECTION REQUESTED• ~~ ` ~o PERMIT NO: ~Q~/ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ~ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASS FAILED ^ COMMENTS: UTILTTIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ELECTRICAL: ^ ROUGH IN ^ FINAL PE ENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS FAILED ^ PARTIAL ~ ~~ ~ ~ ^ COMMENTS: MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED ^ ^ COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED ^ PRESSURE TEST ^ ^ COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUP CY GRANTED NOTES/REMARKS• ~~ ~~ ~ ~~ _~ ~~ G(' _ F D OPPD URT A - - DATE OF INSPECTION MADE: ~C./ T TO CONNECT SERVICE: ON BY ^.- ~ ~. _. ~ -- ,.~ ~ •~ ; ,~ BUILDING INSPECTION REPORT _~. _ Il_J CITY O~BLAIR ^ WASHINGTON COUNTY _ ^ OTHER {_ ~ :_, LOCATION OF INSPECTION• ~ ~ ~ ° / NAME OF OWNER• - y V!', DATE INSPECTION REQUESTED• ~ ~ D I' lv1t~ TIME INSPECTION REQUESTED• f • ~ u ~ PERMIT NO• TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PAS D FAILED ~ ^ COMMENTS: UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ,'~^ PARTIAL' ^ ^ COMMENTS: ELECTRICAL: ~ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS D FAILED ^ PARTIAL ^ COMMENTS: ----- ------ MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL. • COMMENTS: PASSED FAILED ^ ^ _,j PLUMBING: ^ GROUNDWORK ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PAS D FAILED ^ PRESSURE TEST ~ ^ COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS• DATE OF INSPECTION ~~ TIIV~IF.~ ~ ~ ~ 1_ - FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY - -- -.~ NAME OF OWNER• ~U ~ft~`~{/y7`-J DATE INSPECTION REQUESTED• TYPE OF INSPECTION REQUESTED: CONTRACTOR TIME INSPECTION REQUESTED• PERMTI' NO• CONFERENCE ^STATUS BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED ~ ^ COMMENTS: UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ -WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: .` ELECTRICALS. ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT ~ PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: MECHANICAL: ^ ROUGH-IN ` ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED ^ ^ COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED ^ PRESSURE TEST ^ ^ COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: t ~ ~f L•~ ~~ /~" S /J` ` ~ ~ ~ X ~ j ~~; //, DATE OF INSPECTION FAXED OPPD~BURT REA TO CONNECT SERVICE: ON TIMF.• ~ ~ cam' ~/ BUILDING PLANNING R3ll.5.6.3 Handrail grip size. All required handrails shall be of one of the following types or provide equiva- lent graspability. 1. Type I. Handrails with a circular cross section shall have an outside diameter of at least 11/4 inches (32 mm) and not greater than 2 inches (51 mm). If the handrail is not circular it shall have a perimeter di- mension of at least 4 inches (102 mm) and not greater than 61/q inches (160 mm) with a maxi- mum cross section of dimension of 21/4 inches (57 mm). 2. Type II. Handrails with a perimeter greater than 6 /q inches (160 mm) shall provide a graspable fin- gerrecess area on both sides of the profile. The fin- ger recess shall begin within a distance of 3/4 inch (19 mm) measured vertically from the tallest por- tion of the profile and achieve a depth of at least 5/16 inch (8 mm) within ~/ginch (22 mm) below the widest portion of the profile. This required depth shall continue for atleast3/ginch (10 mm) to alev- el that is not less than 13/4 inches (45 mm) below the tallest portion of the profile. The minimum width of the handrail above the recess shall be 11/4 inches (32 mm) to a maximum of 23/q inches (70 mm). Edges shall have a minimum radius of 0.01 inches (0.25 mm). R3ll.5.7 Illumination. All stairs shall be provided with il- lumination in accordance with Section R303.6. R3ll.5.8 Special stairways. Circular stairways, spiral stair- ways, winders and bulkhead enclosure stairways shall com- plywith all requirements of Section R311.5 except as speci- fied below. R3ll.5.8.1 Spiral stairways. Spiral stairways are per- mitted, provided the minimum width shall be 26 inches (660 mm) with each tread having a 71/2-inches (190 mm) minimum tread depth at 12 inches from the narrower edge. All treads shall be identical, and the rise shall be no more than 91/2 inches (241 mm). A minimum headroom of 6 feet 6 inches (1982 mm) shall be provided. R3ll.5.8.2 Bulkhead enclosure stairways. Stairways serving bulkhead enclosures, not part of the required building egress, providing access from the outside grade level to the basement shall be exempt from the require- ments of Sections R311.4.3 and R311.5 where the maxi- mum height from the basement finished floor level to grade adjacent to the stairway does not exceed 8 feet (2438 mm), and the grade level opening to the stairway is covered by abulkhead enclosure with hinged doors or oth- er approved means. R3ll.6 Ramps. R3ll.6.1 Maximum slope. Ramps shall have a maximum slope of one unit vertical in eight units horizontal (12.5- percentslope). R3ll.6.2 Landings required. A minimum 3-foot-by-3-foot (914 mm by 914 mm) landing shall be provided: 1. At the top and bottom of ramps, 2. Where doors open onto ramps, 3. Where ramps change direction. 123ll.6.3 Handrails required. Handrails shall be provided on at least one side of all ramps exceeding a slope of one uni t vertical in 12 units horizontal (8.33-percent slope). R3ll.6.3.1 Height. Handrail height, measured above the finished surface of the ramp slope, shall be not less than 34 inches (864 mm) and not more than 38 inches (965 mm). R3ll.6.3.2 Handrail grip size. Handrails on ramps shall comply with Section R311.5.6.3. R3ll.6.3.3 Continuity. Handrails where required on ramps shall be continuous for the full length of the ramp. Handrail ends shall be returned or shall terminate in newel posts or safety terminals. Handrails adjacent to a wall shall have a space of not less than 1.5 inches (38 mm) between the wall and the handrails. SECTION R312 GUARDS R312.1 Guards required. Porches, balconies or raised floor surfaces located more than 30 inches (762 mm) above the floor or grade below shall have guards not less than 36 inches (914 mm) in height. Open sides of stairswith a total rise of more than 30 inches (762 mm) above the floor or grade below shall have guards not less than 34 inches (864 mm) in height measured vertically from the nosing of the treads. Porches and decks which are enclosed with insect screening shall be provided with guards where the walking surface is lo- cated more than 30 inches (762 mm) above the floor or grade below. R312.2 Guard opening limitations. Required guards on open sides of stairways, raised floor areas, balconies and porches shall have intermediate rails or ornamental closures which do not allow passage of a sphere 4 inches (102mm) or more in di- ameter. Exceptions: 1. The triangular openings formed by the riser, tread and bottom rail of aguard at the open side of a stairway are permitted to be of such a size that a sphere 6 inches (152 mm) cannot pass through. 2. Openings for required guards on the sides of stair treads shall not allow a sphere 43/g inches (107 mm) to pass through. SECTION R313 SMOKE ALARMS [F] R313.1 Smoke alarms. Smoke alarms shall be installed in I the following locations: 1. In each sleeping room. 2. Outside each separate sleeping area in the immediate vi- cinity of the bedrooms. 52 2003 INTERNATIONAL RESIDENTIAL CODE® BUILDING INSPECTION REPORT ~`Y CTl$Y OF BLAIR ^ WASHIIVGTON COUNTY - ^ OTHER LOCATION OF INSPECTION• ~/ ~O ~ ~~~~~L~ ~' ~f''~ ~~~U~ NAME OF OWNER• ~~2 CONTRACTOR• DATE INSPECTION REQUESTED• ~~ ~ TIME INSPECTION REQUESTED• ~D` U`J PERMTI' NO• ~~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMWG ^ DRYWALL FINAL ^ PARTIAL PASS D FAILED ~ ^ COMMENTS: UTILTI'IES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ELECTRICAL: ^ ROUGH IN FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS FAILED ^ PARTIAL ~ ^ COMMENTS: / MECHAMCAL: ^ ROUGH-IN ^ AlC ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASS FAILED COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN FINAL ^ VJATERMETERINSTALLED ^ PARTIAL PASS FAILED ^ PRESSURE TEST ^ COMMENTS: OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED _ NOTES/REMARKS• TE OF IIVSPECTION F L FAXED OPPD~BURT REA TO CONNECT SERVICE: ON c G CL CJ 4 ~~ City of Blanr ~, ~ ~ ~- 218 South 16 Street , f~.--.~~~ -, ;~~~ Blair, NE 68008 ` - Voice (402) 426-4191 ~~ r'~' ~~~ F~~ ~ ~~,~ {_ 1. Fax (402) 426-4195 ~~'~ ~' <, z, :~. ~~~~~ ' To: o(S U G~ From: ~~ •P~f1 Fax: Pages: Phone: .Date: ~~~ ~~(~ ~~ CC: ^ Urgent ^ For Review ^ Please Comment ^ Please Reply ^ Please Recycle • Comments:. Nee ~ ~~ss ~s~Sr~~J 4 p/at ~/~~ Lot Z ~l~r ~ ,~~~ a CITY OF BLl~IR -~ ~b~ o~~se of a BUILDING PERMIT DEPOSIT AGREEMENT A $200.00 refundable deposit is being collected at the time of your building permit application for all permits $10,0000 and above. However, the City reserves the right to not refund this deposit if any of the following conditions occur during the construction period: 1) theft of water service by either the plumber, owner or general contractor, 2) all required inspections have not been obtained, 3) occupancy occurs prior to a final inspection; 4) all permits-have not been obtained, and 5) the project is - completed without a final inspection being done. 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. ~ i ~~ Contractor/Owner ~ ~. ,~' ~s C6 ~~ Contractor/Owner City of Blair /_\ 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail c'rfyofblair@huntel.net o GTY OF BI,t\II~ a~~_ o~~se of BUILDING PERMIT SUPPORTING DOCUMENTS This building permit packet includes various items dealing with particular code requirements and/or building permit requirements. It in no way includes ALL particular code items. Also, it is your responsibility to know the 2003 International Building Code requirements that apply to your project. Please understand this packet is only designed and distributed to aid-you in -your building permit process. A -copy of the International Building Code is available for your use at the Blair Public Library: I have read the above disclosure and accept this building permit documentation on my own behalf assuming full responsibility as the owner/contractor for this project. i~ f ~ caner/Occupant Ci y of Blair Contractor ~~~~ Date /_\ _~ 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel.net o ~° THOMPSON, DREESSEN & DORMER, INC. Consulting Engineers & Land Surveyors December 18, 2003 Ms. Ramona Norwood 11146 South Street Blair, NE ,68008 RE: Percolation Test Lot 2, Block 7, Oak Park First Addition Washington County, Nebraska TDZ File No. 200-318.93 ROBERT E. DREESSEN, P.E. NELSON J. HYMANS, P.E. JAMES D. WARNER, L.S. CIIARLES E. RIGGS, P.E. KA "KIP" P. SQUIRE ]II, P.E. JOHN M. I{OTTMANN, P.E. ARTHUR D. IIECCARD, P.E. JOSEPH G. KOSINOVSICY, P.E. DOUGLAS S, DREESSEN, P.E. DEAN A. JAEGER, P.E. RICHARD M. BROYLES, L.S. DAVID H. NEEC, L.S. RONALD M. I{OENIG, L.S. CHRIS E. DORMER, L.S. LORAS A. I{LOSTER111ANN, P.E. TIMOTHY T. I'APSTEIN, P.E. MICHAEL J. SMITH, L.S. TROY J. NISSEN, P.E. DOUGLAS E. KELLNER, P.E. DANIEL J. BROWN, P.E. KEVIN L. TRUE, L.S. GARY A. NORTON, P.E, Three percolation tests were performed at the above-referenced location at your request. Test Hole No. 1 was located 5 feet southerly and 25 feet easterly from the northwest property corner. Test Hole No. 2 was located 5 feet southerly and 55 feet easterly from the northwest property corner. Test Hole No. 3 was located 5 feet southerly and 85 feet easterly from the northwest property corner. All three test holes had percolation rates of 13 minutes per inch, indicating that the soils in the area tested are suitable for installation of a conventional septic system lateral field. A boring was located between the test holes and was drilled to a depth of 10 feet. Dark brown clayey silt was found to a depth of 1 foot, followed by light yellow brown clayey silt. i3o free groundwater was found at tb.e time the boring was drilled. These tests were performed in accordance with procedures outlined in current State of Nebraska Department of Environmental Quality regulations concerning soil percolation tests. The soil was tested at Ilormal lateral field depth in the locations described above. If there are changes in the proposed lateral field location, or if site grading is done after the test date, retesting may be necessary. This report has been prepared for the exclusive use of our client in accordance with generally- accepted geoteclulical engineering practices. We would like to emphasize that improper construction methods, improper use of the system, and improper maintenance of the system are beyond our control and, therefore, no other warranty, expressed or implied, is made. 10836 OLD MILL ROAD OMAHA, NEBRASf~11 68154-2685 402-330-8860 FAX 402-330-5866 ;~ rr1~ THOMPSON, DREESSEN o DORMER. INC. ~ °~ ~ Consulting Engineers & Land Surveyors 10836 OLD MILL ROAD OMAHA, NEBRASKA 68154 (402) 330-8860 TO: RAMONA NORWOOD 11146 SOUTH STREET BLAIR, NE 68008 PERCOLATION TEST -x l~VOI CE Invoice Date: December 12,2003 Invoice Number: 57424 lob Number: 200-318-96 ~: LOT 2, BLOCK 7, OAK PARK FIRST ADDITION, WASHMGTON COUNTY, NEBRASKA Terms: Net 30 Days. A finance charge of 1.5% Per Month (I8% Per Annum) Will be Charged on Past Due Accounts. INVOICE AMOUNT $ 400.00 1ZEMITTANCE COPY :~~ ARNEnK NEE ,~0-I;i29~i89 HrO;<R 121 OROERN SLSMN• Arll^ Johnson onnardla Modular Double C PLAN MOr1Ef" DEALER 4USTOMER PON LOCATION pU0' i fll6MAB40 i 17Ba BA ' ~0 Frsmont Homes, Ins. Ames NE 19:' ~'~ Sprr~. ~c I ~', ~:onu CORNER OAS F/P, ON FLOOR, HORTIZONTAL VENT, MAN IEL ABOVE, MIRR~!R LOOSE OMI! CAN LIGHTS, GLASS SHELFS, LEFT OF fRONT ODOR, ANGLE CABINE 13 IN M/R AND 2 CABINETS BEHIND TUB IN MASTER BATH, INS FALL HEAD CABINETS 2rOlASS DOORS. GLASS DOORS WILL 9E ON 801 H SIDES LEFT OF DOOR 6 ANGLE ~: AB. 100 PANTRY ON ODS OF KITCHEN R. OAK ODORS W/OAK STYLES OMIT WINDOW OVER DESK PAS :'f GLASS QVERHEAD OMIT LITE & SHELF 48X49 COR R GAS F/P • • • • • 2 2 ~ WINDOWS 24 2 S r_ v. __ ~•r _ _ a•~• _r I f~, a~oaF ' ~ uwrow ~/ % aoeEaaou It...- I »oeEa~oou d _ • \ r A O ~I - o ,- , , 1. ~ _-.~ 876MAB- ~: ms3F~• ~ -A92o ~2 x 7s' Floor Size ~'.9'-8' x 72'-0' 21 is Sq. FI. uI1T WINDOW OVE I ' ': ~' B6W HYDRANT OVERH l ~ ,'IIGLASS OMIT LITE •;• I:LFS ;~ ~I • TRl'-'1 IN LENDING DISCLOSURE STATEMENT- - (THIS IS NEf;~-.cR A CONTRACT NOR A COMMITMENl_._ ~ LEND) MORTGAGE EXPRESS INC. Borrowers: Property Address: 7200 S. 84TH STREET Donald L Norwood TBD LAVISTA, NE 68128 Ramona Norwood Blair, NE 68008 Loan NO.: Date;- 1/21/2004 ^ Preliminary ^ Flnal Type of Loan: Other, Interest Only (e) means Estimate Rate /Term: 10-500 % / fi months ANNUAL PERCENTAGE FINANCE Amount Total of RATE CHARGE Financed Payments The cost of your credit as a yeady rate. The dollar amount the credit vrill wst you Thls anwunl of uedll provided to you or on The amount you will have patd alter you have assuMng the annual percentage rate does not your behalf. made all payments as scheduletl assuMng the change. annual percentage role does no[ tJ;ange. 11.150 $3,431.89 $123,310.00 $126,741.89 PAYMENT SCHEDULE: Interest on the amount of credit outstanding will be paid monthly. DEMAND FEATURE: ^ This loan does not have a Demand Feature. ~ This loan has a Demand Feature as follows: Principal balance due in 360 months. VARIABLE RATE FEATURE: ^ This Loan has a Variable Feature. Variable Rate Disclosures have been provided to you eadier. SECURITY You are giving a secudly interest in the property located at: TBD, Blair, NE 68008 ^ Collateral securing other loans with us may also secure this loan. ^ Your deposit accounts and other rights you may have to the payment of money from us. ASSUMPTION: Someone buying this property ^ cannot assume the remaining balance due under original mortgage terms. ^ may assume, subject to lender's conditions, the remaining balance due under original mortgage terms. FILING !RECORDING FEES: $ PROPERTY INSURANCE: ^ Property hazard insurance in the amount of with a loss payable clause is a required condition of this loan. Borrower may purchase this insurance from any insurance company acceptable to the lender. Hazard Insurance ^ Is ^ is not available through the lender at an estimated cost of $0.00 fora year term. LATE CHARGES: If your payment is more than 15 days late, you will be charged a late charge of 5.00 % of the over due payment. ^ REQUIRED DEPOSIT: The annual percentage rate does not take into account your required deposit. PREPAYMENT: If you pay off your loan early, you ^ may ^ will not have to pay a penalty. ^ may ^ will not be enOtled to a refund of part of the finance charge. See your contract documents for any additional information regarding non-payment, default,-required repayment in full before scheduled date, and prepayment refunds and penalties. , IANe hereby acknowledge reading and receiving a complete copy of this disclosure. Donald L Norwood BORROWER/DATE BORROWER/DATE Ramona Norwood BORROWER/DATE BORROWER/DATE Byte Fslerpdses, Inc. 1-800-695-1008 (222) CONTRACTORS • Walker Forms; Columbus, Ne. Phone# 1-402-562-1102 Contact is Charles • Henton Trenching Inc.: Blair Ne. Phone # 426-9580 Excavation-septic system-water line • Sunshine Concrete Blair Ne. -426-1828 Flat work • Judt Electric- Blair Ne.: Blair Ne.:-426-5770 • Sapp Bros. Propane: Omaha, Ne. Propane tank and lines to house • Town and Country Plumbing: Blair Ne. 426-1712 Install necessary plumbing in basement floor and connect to house plumbing • Rod Dennison Home improvement: Columbus Ne. 402-64-1839 Carpentry • Getzshmans: Blair Ne.: 533-2355 hvac • Husker Doors -Ellchorn Ne: 727-6700 ask for Chuck Install garage doors R'~4Ti± U~1u1~~RA~xa+ C;;i~n,~~ ai= YY~~HiN~TQN~88 acc :~oe~ 7 ~ ~ I ~ ~. ~NTEIl~i~ i~{ NUM1~~I~A4 INQ~X ~1R Fll_~~ FQR RE~QRD e E'-? ~ THIS.~~.QAY4F~~~-A,[1.2~~ ~ ~, AT,:~.-Q'CI,C~K ~ ~ ~No A~CCA~~~ IN aQOK ~~ ~ -~ ~~ g~ ~ ~ ,~,AT P~G~~~ CfJUN1'Y CI.~RK 1' GztA;?~.~~'T~ ~. "~~~RSv~~ _. AGREEMENT ~~~r.~~,~~~c~.xT~:~~.~~k; This Agreement made this ~ day of ~~Q~~, 20LY , by and between the City of Blair, Nebraska, hereinafter referred to as "Blair", and ~Olncn~~ ~ Denal~J -, hereinafter N~rrv,~~ c~ referred to as "Customer". WITNESSETH: Whereas, Customer has made a request to-Blair and hereby makes .application for water from within the municipality, said water to be utilized at Customer's personal residence, which is located on the following described real estate, to-wit: ~ Z ~f~~lc.~7 C3GtK ~r'~ t-~s~ /~cadi.~6~ Whereas, under the terms and conditions as set forth herein, Blair is willing to sell Customer city water. NOW, THEREFORE, BE IT AGREED by and between the parties that for and in consideration of One,Dollar.and mutual benefits to be derived by both parties hereto, the specific receipt thereof being hereby acknowledged, it is agreed as follo~~~s: 1-. Customer shall be allowed to purchase water from Blair at a place to be designated'by the Director of Public Works of Blair. Prior to installation of the meter and tap, Customer shall submit to the City of Blair plans and specifications acceptable to Blair for such tap and such tap shall be made in accordance with all plans, specifications, and requirements of Blair. Such specifications and requirements _shall include but not be limited to the installation of a back flow preventer. Such tap shall be such size as required by Blair and the Customer shall pay for all supplies and materials, except for the water meter. Customer shall notify Blair, prior to commencement of construction and at { t Jtj 1 ° S `g ~~ ._.~ a. anr~-~~uan~} a~aujw~a~ clays toaa~.uoo siy~ `pa~eu.w~a~ ~Cjjan~nw aajjaea ssaju; ~ ~t 'uoj~oa yons ~.o asua~ap aye u! pa.unou! sasuadxa jia pua `s~soo `saa~ ~Cauao~.a apnjour osle Ifays uoj~ao~.juwapu! yong '~uawaaa6a s!y~ aapun aojnaas aa~enn ~o uojsjnoad ay} woad. ~(ann-~Cua u! 6uj~jnsa.~ sa!anful ao sa6ewap ~o~ ~C~!~ua ao uosaad aay~.o ~Cua ao .~awo~sn~ ayT Aq ~y6noaq pua aanaos~aynn pu!~j ao aan~au pua ~.o ~C~!jjgejj .aay~o Cue ao `sums `uo!~oa }o sasneo `swjajo jja pua ~Cua woad. ajajg ssaiwaeu anas pua ~!uwapu! o~ saaa6a -.aawo~sn~ 'sasodmd uo!~oa~oad aa~. ao} as}ann ~o ~C~!j!gajjana aye ao uo!~oa~o.ad aaj~ ao~. aawo~sn~ woad. aa~ann 6ujniaoa.a suosaad .ao uos~ad aay~o pua ao _ aawo~sn~ ~, ,c ~~,.,-„~ c. a _ v} n~.i~iyc~~ nuC onGy .a0u .iv} ajgisuvusaJ aq :}vi.i jjays- .iiGj~ '.iawo}sill nq paziji~nl ao pa~ona~suoo wa}s~Cs aa~enn ao auti ~Cua o~ sa-adaa ao aouaua~ujew ao~ ~C~!jtgjsuodsa.~ ~o ~C~!jlgajj ou aney jjays ata18 'sa!oua6a e~jsaagaN ~o a~a~S due ~Cq pa.-jnbaa aq Caw sa aaTann ~Cjddns ~(ew aawo~sn~ yo!ynn o} wa~s~Cs fua ao~ sao~a~ado pasuaojj apjnoad o~ ~C~!jigjsuodsaa .ao ~C~jj!gag ou anay hays ~!a18 'wa~s~Cs ~a~ann jad-ojunw ay~.~.o died a sa paaap!suoo aq wa~s~Cs aa~snn jed!o!unw aye o~u! dad aye puol~aq ~awo~sn~ ~Cq paz!j!}n ~o pa~ona~suoo wa}s~(s aa~ann ~(ue jjays .you lob. ajgjsuodsaa you s! a!a18 ~.o ~.!~ aye ~ey~ paaa6a pue poo~saapun aay}an~. si ~j waTsls aaTann jad!ojunw aye o~ uo!~oauuoo aa~.a aawo~sn~ o} papjnoad aa~ann aye . ~o ~C~g~nb ao `aanssaad `~C~!oojan `awnjon aye o~ se s~uaaaann ao `s~uauanoo `suoj}a~uasaadaa ou sa~jaw ara18 fey} o~aaay salad ay} uaan~}aq pua ~Cq paa~6a s! ~j ~~ 'uaa}s~Cs aa~ann s,ara18 0~ uo!~oauuoo ~o aw-~ aye o~ aoud aa~. dad 00.052 ~ a -~!al8 0~ ~Ced osja jjays ~awo~sn~ 'aowas ~o aouanu~~uoos!p ao~ saanpaooad plepua~s pua j~nsn s,a!a18 0} ~oafgns aq {jays aawo~sn~ 'z 'pawao~ad aq uao a!a18 /Cq uo!~oadsuj ~ay~ os paw~o~ad aq p-nn day} uo!~ona~suoo aye s~jaoM oljgnd ~.o ~o~oaa!Q aye-~(q pa~!oads sa sjan~a~uj yons ~;.°.,~~ =~_, `~. (25) .years from the date hereof. 5. The charges by Blair to Customer for water provided may be adjusted from time to time by the Mayor and City Council of Blair. The Customer shall also be subject to all other rules and regulations of the City of Blair as pertains to its customers of the municipal water system, including but not limited to payment, deposit, and shut off regulations. 6. This agreement shall be binding upon the heirs, personal representatives, successors, and assigns of Customer. This agreement shall also specifically run with the land with respect to the real estate described hereinabove and shall be binding upon all grantees, assignees, and subsequent owners of such real estate. The Customer shall be responsible for and shall fife a copy of this agreement against said read estate in the office of the County Clerk of Washington County, Nebraska, prior to Blair's. providing water service to the premises. CITY OF BLAIR, NEBRASKA Ja Ralph, Mayor ATTEST: .~ Brenda Tayior, City Cier' ~. ..:~ ~ ~ ~_r. . ustomer Address ,~ l~~r~ ~~ ~~~~ Aug. 3. 2004 3~56PM WASHINGTON CO PLANNING4024266843 Q~~ d~, ~ ~}~e ~kSS ~ ~nl~f/ Ar.~ p No~9138 P~ 1/1 C~ '"' ~ ^ ~ f'Q '-t ~! ~ d~P SS ~~ r2 le~rno~q a- ~ou~(~ ~orc~Joo~ ~ Lor Z~ ~loc~ ~~ Oak ~y~~ ~s~- ~dC~i~-i(~Y1 ~ydur ~~ ia,i-r) D ~~ 5 ~ ~ ~ ~ r~SS ~ S a f ~ ~ Z g ~ ~~m bler~ dg~ ~~ 3 /~ 1~'L ~i41ti/1 A CT~N U ~ Yl~ ~ot~l~ C' ~ ~~_ , rfi/1 I~ rl n _ r Sep.16~ 2004 5~50PM WASHINGTON CO PLANNING4024266843 No.0090 P, 1/1 ~ ~~ a~, Tc~Ry T I~S-rn~~e~ ~-9fl ~)ue ~~si~~iT ~~ 11281„ ~~-~ bIP ~;~q~ I I~(c~ r ~JOO ~ s ~~`~~ ~ ~J ~~. y~~~ dp ~~o~~~