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We, understand as the owner of the property, that we, our heirs or our assignees are
respbiiible for the perpetual care, maintenance and removal of said tree(s), and we agree to
not plant any tree(s) closer than ten (10) feet to a curb or fifteen (1.5) feet from the shoulder of
the road if there is no curb. We also agree not to plant any tree(s) within six (6) feet of any
public sidewalk, and all tree(s) planted will be in conformance with Section 6-319 of the Blair
Municipal Code.
lit zie,
Signature of Owner(s)
STATE OF NEBRASKA )
WASHINGTON COUNTY )
The foregoing instrument was acknowledged before me onp � ? , 201 CJ , by
l vl l owner(s) of the above stated real property.
For Office Use Only
PERMIT
Date
GENERAL NOTARY-State of Nebraska
BARBARA J. BRAZELTON
My Comm. Exp. Jan. 1, 2012
Date Permit Paid. r 70 Receipt # (26 7 lG' Approved by:
My commission expires: /, — -�
WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR
o -o DWG: C: \Documents and Settings \kriens \My Documents \Drawing2.dwg USER: kriens
g ° DATE: Sep 25, 2009 8:51am XREFS: 080169_ASBUILT 80169_XBASE 80169_PBASE
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