PAID INVOICE (2).TIF City of Blair Paid Invoice
Page 1 of 1
218 S 16th Street
Blair, NE 68008 DATE INVOICE #
4 � o " ) ?/So o1 a� Phone: (402) 426 -4191
12/4/2012 2012 -01374
Fax: (402) 426 -4195
PAID DATE 12/4/2012
ACCOUNT:
All American Pro
17814 County Rd. 25 PERMIT NUMBER MS- 2012 -00552
HERMAN NE 68029 1419 Grant St
BC LOT 2 PT OF VAC ST BLK 67 114 PC 2
Phone: 402 5719 Blair, NE 68008
Amount
Date Status Payment
115.00
12/4/2012 Original Due
( -) 115.00
12/4/2012 Paid Check Receipt #32290 65 on ck 1284-holding 50 deposit ck #1283
Total Paid 115.00
I hereby certify that I hav read and examined this application and know the same to be true and correct. All
rov' s of
ignature of Contractor or Authorized Agent
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