929 Washington St
PE~~IT TO MOVE BUILDING OR DEMOLISH STRUCTURE
~--=----....
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Fee paid:~.oO /
Owner: n -'d L/
Name: rfL~~~
Address: H fl @ i?/)pI ()c;lI
~q)1 ~q "c;IS'76
Date:
7- 'iJ- 97
. Cum:ractu.L:' S'<~ VM- '<2~
Name:
Address:
\" "
The above described person is hereby granted a permit to (Mov~) or
~2" a building feet long, and feet high,
now located on
, City of Blair, Nebraska, to be
fJi<? I.<j;;-"j;'r"'u~ The ~
S:,t"frfeci
be ,dG.Ue on and shall take
finally located on
((~~~ is to
~.~~u~~~.
The route to be taken in the removal thereof is as
folIo
and numbers of the streets, alleys,
or public
thereof shall be under the direction of the Street Commissioner
Public Works. . The building is to be used for
purposes.
.---)7 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 ~or demolished
have been fully paid was received
and is attached.
, --7 A ~te surety bond or two 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 such building was received on
and is attached.
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City Clerk
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City Administrator
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S ((:VJ-yU::
;y
ot
(\(:<:ur:tence $
as fA nlalLr:~r 01
as
does not alter or the
event of cancellation of the hability insurance under
endeavor to give not less than ten (0) days to the certificate
notice shall impose nO obl1gation or any lund
to
Dr
I
Ju I. 9. 1997 3: 33PM FARM BUREAU
P"I'\HM ~u Mt.ITUtlL INStJRIWCt COMPANY
FAAM 8UF/EAf.11.JF! INS/JRIWCE COMPANY
. FARM elJAEAu MUTUAL FUNOS
FBL INSIJRA/IK:.ti BFIOKERAGE, /NC.
~ 0$ MOINES. l:lIVA
SOV'n-IlW<OTA FARM Bf.1REAU
MUTUAl. fNSlIFIANCE COMPANy
~ SOIJTk cwroTA
t.mH FARM BURC:AU
IIVSURMICE COMPANY
SAl.7 ~ CITY. V'W1
~mw FARM lWRtAu
uq /NSUIWJCE COMPANY
~ 00t0ll>4D0
E TEAM
-.
Farm Bureau
FINANCIAL SERVICES
No, 5684 . p, 1
July 9t 1997
MR JOHN SAMPSON
Re;
Policy Number:
S105988 DA V1D GEISE
Dear MR SAMPSON;
TInS IS THE NOTE YOU REQUESTED REGARDING LIABiliTY COVERAGE
FOR MR GEISE.
ACCORDING TO ALL THE CONDmONS AND TERMS OF THE POllCY THE
OCCURRENCE OF TEARING DOWN THE TWO QUONSETS FOR FARM USE IS
A COVERED OCCURRENCE UNDER THE FARM OWNERS POLICY.
uy~~
Sandra Wheat .
Sr. Farm and Ranch Underwriter
Farm Bureau Mutual Insurance Co.
5400 UNTVERS17Y AWiNUE WEST DES MOiNes. IOW.A 50256-5997 PH (515) 225-64OD
FARM BUREAU MUTUAL INSURANCE COMPANY
FARM BUREAU LIFE INSURANCE COMPANY
mRM BUREAU MUTUAL FUNDS
" BL INSURANCE BROKERAGE, INC.
WEST DES MOINES, IOWA
SOUTH DAKOTA FARM BUREAU
MUTUAL INSURANCE COMPANY
HURON, SOUTH DAKOTA
UTAH FARM BUREAU
INSURANCE COMPANY
SALT LAKE CITY, UTAH
WESTERN FARM BUREAU
LIFE INSURANCE COMPANY
DENVER, COLORADO
IA - 43
Farm
FINANCIAL SERVICES
LIABILITY INSURANCE CERTIFICATE
To:
.
For: Policy Number S105988
CITY HALL
218 S 16TH
BLAIR NE 68008
David W. Geise
2743 Monroe Ave
Logan IA 51546
Effective: July 8, 1997
Expiration: August 8, 1997
.
TYPE OF INSURANCE
[] Farm Liability (Not Automobile)
o Personal Liability (N ot Automobile)
o
LIMIT
Bodily Injury Liability
and
Property Damage Liability each occurrence $ 300,000
This certificate, issued by Farm Bureau Mutual Insurance Company
certifies that liability insurance is afforded as shown above. It is issued as a matter of
information only and does not amend, alter or extend any of the coverages in the policy,
In the event of cancellation of the liability insurance afforded under this certificate, we will
endeavor to give not less than ten (10) days notice to the certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company, its
agents or representatives.
July 9, 1997
cc: Insured
County
Agent
File
542-400(3-90)
5400 UNIVERSITY AVENUE WEST DES MOINES, IOWA 50266-5997 PH (515) 225-5400