936 Grant StreetPrepared by and after Recording Return to:
Brenda Wheeler, City Clerk, City of Blair, 218 S. 16th Street, Blair, NE 68008 (402) 426-6694
DATE OF INSTRUMENT: ` { , 20
WAIVER FOR KEY LOCK BOX SAFETY REQUIREMENT
The undersigned, hereinafter referred to as "Owner", whether one or more, of the
following property, is required by Section 9-201.01 of the Municipal Code of the City of
Blair to install a key lock box for access to the premises by the Blair Volunteer Fire
Department.
Owner warrants and represents that he/she is owner of the following described real
estate:
LEGAL: Lot Seven (7), Eight (8), Nine (9), Ten (10), Eleven (11) and Twelve (12), Block Eighty -
Six (86), City of Blair, Washington County, Nebraska
ADDRESS: 936 Grant St, Blair, NE 68008
PIN: 890046956
Owner hereby specifically acknowledges the following:
1. Owner acknowledges that the Blair Volunteer Fire Department encourages all
owners of buildings not regularly occupied for twenty-four (24) hours every day
for seven (7) days of the week to install a key lock box to provide safe and
immediate access to the building in case of fire or emergency.
2. Owner acknowledges that the Blair Volunteer Fire Department enforces rules
and regulations for the authorized use of the key lock box system by fire
department personnel and volunteers.
3. Owner acknowledges the following safety benefits derived from installing and
using a key lock box:
a. Immediate building entry by firefighters without waiting for building keys.
b. Eliminate needless forced -entry damage.
c. If a fire alarm is installed, maintain building security after an alarm
investigation by allowing the fire department to relock the undamaged
building.
d. If a sprinkler system is installed, immediate building entry will help protect
inventory, equipment and supplies from unnecessary water damage
caused by delayed sprinkler shut-off.
Pagel of 3 2019-03949
Recorded
WASHINGTON COUNTY NEBRASKA
General
Filed for record on December 10, 2019 at 09:57 AM
Numerical
Instrument No. 2019-03949
Photostat
Proofedr"
Scanned
Carolyn Stodola, Register of Deeds
Prepared by and after Recording Return to:
Brenda Wheeler, City Clerk, City of Blair, 218 S. 16th Street, Blair, NE 68008 (402) 426-6694
DATE OF INSTRUMENT: ` { , 20
WAIVER FOR KEY LOCK BOX SAFETY REQUIREMENT
The undersigned, hereinafter referred to as "Owner", whether one or more, of the
following property, is required by Section 9-201.01 of the Municipal Code of the City of
Blair to install a key lock box for access to the premises by the Blair Volunteer Fire
Department.
Owner warrants and represents that he/she is owner of the following described real
estate:
LEGAL: Lot Seven (7), Eight (8), Nine (9), Ten (10), Eleven (11) and Twelve (12), Block Eighty -
Six (86), City of Blair, Washington County, Nebraska
ADDRESS: 936 Grant St, Blair, NE 68008
PIN: 890046956
Owner hereby specifically acknowledges the following:
1. Owner acknowledges that the Blair Volunteer Fire Department encourages all
owners of buildings not regularly occupied for twenty-four (24) hours every day
for seven (7) days of the week to install a key lock box to provide safe and
immediate access to the building in case of fire or emergency.
2. Owner acknowledges that the Blair Volunteer Fire Department enforces rules
and regulations for the authorized use of the key lock box system by fire
department personnel and volunteers.
3. Owner acknowledges the following safety benefits derived from installing and
using a key lock box:
a. Immediate building entry by firefighters without waiting for building keys.
b. Eliminate needless forced -entry damage.
c. If a fire alarm is installed, maintain building security after an alarm
investigation by allowing the fire department to relock the undamaged
building.
d. If a sprinkler system is installed, immediate building entry will help protect
inventory, equipment and supplies from unnecessary water damage
caused by delayed sprinkler shut-off.
Pagel of 3 2019-03949
4. Owner acknowledges that without a key lock box the Blair Volunteer Fire
Department during a fire call will gain access into the building through whatever
alternative means are available to them.
5. Owner acknowledges and agrees that this waiver releases, waives and
discharges the City of Blair and the Blair Volunteer Fire Department, their
employees, officers, directors, agents, representatives, and management (hereby
referred to as "Releasees") for any and all loss or damage to the property caused
by a forced entry into the property that occurs within the normal scope of the Blair
Fire Department operating procedure.
6. Owner hereby agrees to indemnify and hold harmless the Releasees from any
loss, liability, damage, or cost they may incur arising out of the entry.
7. Owner hereby assumes full responsibility for any property damage arising out of
the entry and hereby acknowledges that the activities involved are of a
hazardous nature and contain inherent risks of serious property damage.
8. Owner also expressly acknowledges that this waiver extends to all acts of entry
by rescue operations and is intended to be as broad and inclusive as is permitted
by the laws of the State and that if any portion thereof is held
CERTIFICATION BY APPLICANT
I, Hipnar Properties LLC a Nebraska Limited Liability Company, certify that I have read
and understand the acknowledgements and requirements listed above. I hereby request
the City of Blair to waive the Key Lock Box Safety Requirement for my business located
at the above described real estate. I further understand that should the Blair Volunteer
Fire Department be required to gain access into the building through alternative means,
I agree to release, indemnify, and save harmless the Blair Volunteer Fire Department,
and the City of Blair, from any and all causes of action, damages, claims, suits or any
other liability of any nature or kind arising out of or resulting from such access to the
structure by the Blair Volunteer Fire Department.
Dated: Ll 20
Hipnar Properties, LLC a Nebraska Limited Liability Company, Owner(s)
STATE OF NEBRASKA)
) ss
WASHINGTON COUNTY)
The foregoing instrument was acknowledged before me on rr l b c- 20
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GENERAL NOTARY -State of Nebraska NOTARY PUBLIC
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Page 2 of 3 2019 —039 49
Approving Official:
Phil Green, Assistant City Administrator
Distribution List:
1. Fire Chief of the Blair Volunteer Fire Department
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