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City of Blair Paid Invoice Summary
218 S 16th Street Page 1 of 1
Blair, NE 68008 DATE 1/10/2011
'Om/ 01 a� Phone: (402) 426 -4191
Fax: (402) 426 -4195
ACCOUNT:
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Nielsen Construction Co -Blair
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1730 State St PERMIT NUMBER RN- 2010 -00209 j
BLAIR NE 68008 -1568 9999 Hwy 91 j
Phone: 402-426-2059 Blair, NE
Date Reference Number Invoice Number FeeCat Description Status Amount
1110/2011 RN- 2010 -00209 2011 -00264 0100020229 Building Permit Deposit Paid ( -) 500.00
1/10/2011 RN- 2010 -00209 2011 -00264 0100042024 Building Permit Issuance Fee Paid (- )25.00
1/10/2011 RN- 2010 -00209 2011 -00264 01- 009 -4264 Building Permit Fees Paid 2048.00
Date InvoiceNum Status Payment Amount
1/10/2011 2011 -00264 OriginalDue 2573.00
1/10/2011 2011 -00264 Paid Check rec 27766 ( -) 2573.00
Total Paid 2,573.00
I hereby certify that I have read and examined this application and know the same to be true and correct. All
provisions of laws.
Signature of Contractor or Authorized Agent
Save Time & Money with Online Permits and Inspections. Go To: www.buildingdepartment.com
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City of Blair Paid Invoice Summary
218 S 16th Street Page 1 of 1
Blair, NE 68008
_ DATE 1/7/2011
/Se OI Phone: (402) 426 -4191
Fax: (402) 426 -4195
ACCOUNT:
Nielsen Construction Co -Blair
1730 State St PERMIT NUMBER RN- 2010 -00209
BLAIR NE 68008 -1568 9999 Hwy 91
Phone:402- 426 -2059 Blair, NE
Date Reference Number Invoice Number FeeCat Description Status Amount
11/19/2010 RN- 2010 -00209 2010 -00362 0100020229 Building Permit Deposit Paid (- )500.00
11/19/2010 RN- 2010 -00209 2010 -00362 0100042024 Building Permit Fees Paid ( -) 3652.00
11/19/2010 RN- 2010 -00209 2010 -00362 0100042024 Building Permit Issuance Fee Paid (- )25.00
Date InvoiceNum Status Payment Amount
11/1912010 2010 -00362 Original Due 4177.00
11/19/2010 2010 -00362 Paid Check Rec27766 ( -) 4177.00
Total Paid 4,177.00
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I hereby certify that I have read and examined this application and know the same to be true and correct. All
provisions of laws.
I
Signature of Contractor or Authorized Agent
Save Time & Money with Online Permits and Inspections. Go To: www.buildingdepartment.com