CN-2012-00099_0001 (3).tif r U, l
Sep 05 12 01:28p KRW Construction °' J 4024260685 p,1
STATE OF NEBRASKA -- STATE F IRE MARSHA.
246 South 14' Street
Lincoln, NE 68508 -1804
ORDER FORM
ORDER NUMBER ...... . .. . .......... 083002 -12
DATE OF INSPEC'TION ............. 8 -30 -12
OWNER .. ............................... Steve Wehrl
OCCUPANT ............................ KRW Construction
ADDRESS .............................. 414 So. 5'
CITY/ TOWN ........................... Blair
COUNTY . .......................... . ... Washington
HOW OCCUPIED....... .............. New storage building
FEE CARD YES[] NO REVISIT DATE
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Order # M07120 -12 completed.
Facility is approved for occupancy at time of inspection.
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If you have questions on this Order, contact the District B State Fire Marshal Office at 402.395.2164.
Or mail at. State Fire Marshal Office, District B Office, 438 West Market, Albion, NE, 68620 - 1241
All items must be corrected to comply with the laws of the State Vf Nebraska and with rides and regulations adopted by the
]Nebraska State Fire Marshal as mandated by Sections 81 -502 to 81-541, 01
It i5 the duty of the owner orperson in charge of the above -named fac11ity or localion to immediately take measures to bring
the
.facitity into cornpliarace with state regulations,
AL CORRECTIONS SHALL BE rKADi< AND
A LL TT EM S ! C ' - .VRRE CT 1L' D (X G'.'d�w F' E: i
Any damage proximately caused by a failure to remedy the above listed deficiencies shall be deemed to be the sole
responsibility of the owner or person in charge by virtue of this notification and order.
Witness my electron icatly typed name at Humphrey, Nebraska, this day of August 30, 2012,
By: Phone Number: 402 395-2164
CHIEF DEPUTY STATE FIRE MARSHAL
State Fire Marshal E -Form 10 -2004 Page 1 of 1 Corrections Order
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