1348 State StFee Paid: $15.00
Name:
Permit to Move Building or Demolish Structure
Date: �c)i /6, 4)
Owner
Address: )157 A/: (3 �� Address:
The above described person is hereby granted a permit to (Move) or (Demolish) a
building feet long, and feet high, now located on
City of Blair, Nebraska, to be finally located on
(Demolition) is to be done on
Name: / it
Contractor
. The (Move) or
and shall take k.: hours. The
route to be taken in the removal thereof is as follows: (Here designate the names and
numbers of the streets, alleys, or public grounds to be crossed):
City p
City Adiistrator
The removal thereof shall be under the direction of the Street Commissioner and the
Director of Public Works. The building is to be used for purposes.
A statement that all taxes and special assessments on the building to be moved or
demolished and on the land from which it is to be moved or demolished have been fully
paid was received 76 /1t, /67 and is attached. A corporate surety bond or two (2)
personal sureties to pay all damages that may be sustained to any property, public or
private, and including curbs, paving, manholes, public utility lines and pipes, by reason of
the moving or demolishing of such building was received on
and is attached.
TYPE OF INSPECTION REQUESTED:
ING INS "EF T
❑ CITY OF BLAIR ❑ WASHINGTON COUNTY
LOCATION OF INSPECTION:
NAME OF OWNER
CONTRACTOR
DATE INSPECTION REQUESTED: TIME INSPECTION REQUESTED: PERMIT NO
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
COMMENTS:
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
❑ PARTIAL
COMMENTS:
ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT ASSED FAILED
❑ PARTIAL ❑ ❑
COMMENTS:
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
COMMENTS:
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS
FAXED OPPD\BURT REA
ai
❑ OTHER
INSPTOR•. DATE OF INSPECTION MADE:
ITT E
TO CONNECT SERVICE: ON BY
❑ CONFERENCE ❑ STATUS CHECK
PASSED FAILED
PASS
FAILED
PASSED FAILED
❑ ❑
/V4,2,4,,E /, 4",
October 15, 2002
Dan Veskerna
Concrete Equipment Company, Inc.
237 N. 13 Street
Blair, Nebraska 68008
Subject: 1318 State Street building
Dear Mr. Veskerna,
CITY OF I3LAIQ
We have reviewed the October 4, 2002 correspondence from Liberty Mutual. The
items in the letter are not acceptable. We have never had to agree to these terms when a
"practice burn" occurs.
If you do not wish to have the burn under these terms, you are notified to
demolish the structure and remove the debris immediately. Thank you.
Sincerely,
Brenda Taylor
City Clerk
Cc: John Samson
218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 • E -mail ciiyofblair @huntel.net
OPPOPTUXT
October 4, 2002
Mr. Dan Veskrna
Concrete Equipment Company Inc
237 N 13 St
Blair, NE 68008
Subject: 1318 State Street building
Dear Mr. Veskrna,
In regard to the insured location at 1318 State Street, as you know your Liberty Mutual
Insurance policy provides premises liability only. We do not provide property insurance
on the house, garage on any of its contents at this location.
In addition, from your conversation with the City of Blair, it is understood that in the
event any of the firefighters are injured while on the said property that the city's workers
compensation insurance shall cover such loss. It is also understood that the city has
adequate insurance to cover any damage to adjacent properties in the event the fire
department is negligent in burning the buildings.
It is also understood that the city of Blair will hold Concrete Equipment Co harmless and
waive any subrogation rights for any workers compensation insurance losses due to the
controlled burning of these buildings. Concrete Equipment Co will also be named as
additional insured in regards to City of Blair's general liability policy.
Please contact me at 402 - 393 -4041 x226 if you have any questions or need additional
information.
William Unger, CPCU /
Senior Account Representative
Liberty Mutual Insurance Co.
Helping People Live Safer, More Secure Lives.
l Group
AL INSURANCE GROUP
[)GE ROAD = +05
8114
162 -0015
393 --4041
2321
KAY J. ERWIN COUNTY TREASURER
P.O. Box 348 ® Blair, Nebraska 68008
(402) 426 -6888
DATE ' ()
TO WHOM IT MAY CONCERN:
ON THIS DAY C,( ))
PAID THE TAXES ON '
`) .6 -7 hf FOR THE YEARS OF (DOA
PLEASE CONTACT OUR OFFICE IF
THERE ARE ANY QUESTIONS REGARDING PAYMENT MADE,
THANK YOU,
KAY J. ERWIN
BY /I /1
Liberty
Mutual.
October 15, 2002
Mr. Dan Veskrna
Concrete Equipment Company Inc
237 N 13 St
Blair, NE 68008
Subject: 1318 State Street building
Dear Mr. Veskma,
In regard to the insured location at 1318 State Street, as you know your Liberty Mutual
Insurance policy provides premises liability only We do not provide property insurance
on the house, garage on any of its contents at the 1318 State Street location.
Please contact me at 402 - 393 -4041 x226 if you have any questions or need additional
information.
William Unger, CPCU
Senior Account Representative
Liberty Mutual Insurance Co.
rf.A F -
`P� Br7
Liberty Mutual Group
LIBERTY MUTUAL INSURANCE GROUP
9290 WEST DODGE ROAD F 405
OMAHA, NE 68114
WATTS: (800) 462.0015
PHONE! (402) 393 -4041
FAX: (402) 392.2321
Helping People th'e Safer, More Secure Li v'
T /T'd 9bT'ON 3N UH'WO ldfIfW A1d3gI1 Wd9t':17 2002'ST'130