ms-2010-00001_0001-1.jpg CITY OF BLAIR — MISCELLANEOUS BUILDING PERMIT P1
a Permit # --W,6 4) �
A Promis
Date: Approximate Completion Date: " l�� G Site Plan Attached:
Estimated Valuation of Project: o?. 00 O°
Application for Permit Fee $40 + Issuance Fee $25 + $50 Deposit Fee: $115.00
Egress Window (floor plan drawing required)
Fences (plot plan required)
Gazebos (plot plan required)
Patios /Driveways /Sidewalks (new or replacement)
Roofing/Siding/Soff it and /or Eave Repair /Gutters
Swimming Pools with Fence (plot plan required)
Window /Door Replacement (size change only)
Miscellaneous Building Permits (items not covered by one of the above)
Description:
Utility Excavation and Curb Grinding Fee: $75 plus bond
Curb Grind
Length
Utility Excavation
Length Lin. Ft.; Width Lin. Ft
Type: Water ; Sewer ; Other
Amount of Bond Posted: Bond Check #
(Curb grind - $9.00 per Lin. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
Additional Description of project if necess K ii):G4�l�OLy cYN� G��
7 �/G /) & G{p D 14,9
PROJECT INFORMATION:
Job Address: / N l �✓ y�'
Legal Description (if applicable) 2aC'�- 11 9- 85�y`7
Owner &d& &idl� Address: I #1 Phone #: %0 M) l
r
Contractor: Z� Phone #:
Address: �� /� ���{� Cell #: