CASH DEPOSIT ACKNOWLEDGEMENT.TIF C
BLAI
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Acknowledgement of Cash Deposit
I acknowledge that I have received the
Please print name
.00 cash deposit that was held by the City of Blair for my building permit.
Building Permit
w - cupant /Contractor Date
1.J —
01POA U—
218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cityofblalr @cl.blair.ne.us