South & 19th St
7Jj()T Pi 4P ~.
-
PE~~IT TO MOVE BUILDING OR DEMOLISH STRUCTURE
Fee Paid: $15.00
Date:
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Owner:
Name :l1m:udJC', rAkuu G, Ikk 1YI561t.
Address :;:S6,!/{;"V't~~af<l. BI/I/~J12-
Contractor:
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Name: '. /'//.1/.' ,',
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Address:
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The above described person is hereby granted a permit to~~ or
(Demolish) a buildingc...~".Xdr' / feet J::lmg, and'
now located on 5~= Lt::ne...' br. S~I//h'1'19 ~, City of Blair,
;;~ ~\'- ~~~~c. y' .~, /Y'';/ }:' ~~2_Y: _ /~,~-;.-.! /N ,j /:.;/~ / \{~
fin~lly. lo~ated on:r~~=~Y'#~:~IVi7,pi..f'Mt*1S~~
~,v {~'7cf2 r? ,,of If N 10"> dc" '7?owidc:"~1.c:;i!f[:t:i'f!l,:/~I.-m~re
(Demolition) is to be done on (U;;; ,it"
/ / feet high,
Nebraska, to be
The@~ or
and shall take
<;' -,.-'
l
L~ hours. The route to be taken in the removal thereof is as
follows: (Here designate the names and numbers of the streets, alleys,
"',j 'L)
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il ?-",,' ///1/' //1.1,"7/ _O~ h"j
or public grounds to be 'crossed) :'.j. ,0>::>'
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A/(i/ /"'(; :'1' il~~,,; > h ':;=) i~i/~y/ "/-~'<'?:i:;C':{' "
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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
:5;'<;,/(_1// '. /
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
Ill/It-
and is attached.
A corporate 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.
We~/ Ihf} IJ ~ ',1 I'~ A~(1/~~
City Clerk
-,
'., A~;..III..C:ERJ'IFI:~AJEOF IN~~RAI,\IGI:-: .'
PRODUCER
CSR SO
>..-:.;...,.;..:::...., IiANGZ':"]/:.:'. . 12/06/95
THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMA nON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
DATE IMM/DDIYYI
Maguire Agency, Inc.
1935 West County Road B-2,#241
Roseville MN 55113
Phone No. 612 -63 8 - 9100 FIX No.
INSURED
COMPANY
A St. Paul Companies
COMPANY
B
~ange House, Building and
~in Movers
Route 2, Box 130A
Scribner HE 68057
COMPANY
C
COMPANY
o
..." ............'...'... :::.:.'.:: .,.. P" '...'.....'..'... .... ,..... ..
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POUCY EXPIRATION llMrTS
lTR DATE (MMIDOIYYI DATE IMMIDDIYYI
~ERAL lIABllrTY GENERAL AGGREGATE $ 1
COMMERCIAL GENERAL llABIUTY PRODUCTS. COMP/OP AGG $
(: I CLAIMS MADE 0 OCCUR PERSONAL ell ADV INJURY $
OWNER'S ell CONTRACTOR'S PRDT EACH OCCURRENCE $
>--
FIRE DAMAGE (Any onl flrel $
>--
MED EXP (Anyone personl $
~TOMOBILE lIABILITY COMBINED SINGLE liMIT $500,000
A X ANY AUTO CX06308029 09/16/95 09/16/96
i--""-
ALL OWNED AUTOS BOOll Y INJURY
- $
_ SCHEDULED AUTOS (Per personl
~ HIRED AUTOS BODilY INJURY $
~ NON-OWNED AUTOS - (Per accidentl t-
,-
I-- PROPERTY DAMAGE
GARAGElIABlLITY AUTO ONLY - EA ACCIDENT .
-
_ ANY AUTO OTHER THAN AUTO ONLY: <'.
EACH ACCIDENT .
-
AGGREGATE $
EXCESS lIABlUTY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELlA FORM $
WORKERS COMPENSATION AND I STATUTORY UMITS :'.::;':
EMPlOYERS' lIABILITY EACH ACCIDENT .
THE PROPRIETOR! R INCl OISEASE - POUCY liMIT $
PARTNERSIEXECUTIVE
OFFICERS ARE: EXCl DISEASE - EACH EMPLOYEE $
OTHER
A Automobile CX06308029 09/16/95 09/16/96 $100.00 Ded. Compo
Physical Damage $250.00 Ded. ColI.
DESCRlmON OF OPERATIONS/LOCATIONSNEHIClESISPECIAL ITEMS
RB: 1995 G.M.C. Pickup, M#TX20953, S#lGTGX29X3SB533670
Certificate holder is Loss Payee and Additional Insured as respects the
referenced vehicle.
CEfp:l~,gAnM;f..9~R~fII}
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GMACPDP
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES SE CANCEllED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY Will ENDEAVOR TO MAil
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEO TO THE lEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBUGATIONOR UABllITY
OF ANY KIND UPON THE COMPi\NY.ITS AGENtS OR REPI\JjSENTATlVES.
..:,.,::v~ .2{.~~DiO~ON19"
GMAC
c/o PDP Services
7th Floor, Executive Plaza IV
Hunt Valley MD 21031-1053
ACORD25,~S(3/931(t