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BP11713.tif Re- (P130 los v* 6 City of Blair Building Permit Detail Permit #: 11713 Issued: 1 010 6/20 0 4 Type: Residential - New Construction Completed: 06/30/2005 Valuation: 150000 Location: 11302 Rambieridge Dr Owner: Paul Brusegaard Permit Fee: 675 Address: 5801 N. 90th Street Issue Fee: 15 Deposit Amt.: 200 Omaha, NE 68134 Receipt #: 12823 Phone: 402 572 7773 Section: Township: Range: Subdivision: OAK PARK I Lot: 4 Block: 3 Ranch -2 bedroom, unfinished walkout basement; 3 car attache garage next to utility room; deck in rear approximately IT off of ground off kitchen and bathroom; lot 25,684 sq. ft.; 3923 total sq. ft.; 1622 finished area Contractors Environmental Systems Service, Inc. General Contractor Permit # Issued Century Electric, Inc. Electrical Subcontractor E2089 12/1012004 Environmental Systems Service, Inc. Heating Subcontractor M1126 10/0612004 Haman Trenching, Inc. Plumbing Subcontractor P1222 0310412005 Redden Plumbing Plumbing Subcontractor P1193 12/22/2004 Remarks 011102005 DEM Building site requires a sift fence installed to prevent dirt from falling into ditch or affecting county road. 02!182005 DEM All inspection on hold unfit such time as teh sift fence is installed to prevent dirt or mud from going into the ditch. 02252005 DEM Exhaust shall vent directly to outside. Exterior basement shall wiring as required by code for finished wall (switches and recp.'s) Pressure test on plumbing. #100 water and #5 sewer. 08102/2005 DEM Deck rails not complete cover underside of stairs address for house not installed. Inspections Date By 11)242004 KAR Footings Pass 1211312004 DEM Electrical Temporary Service Pass 0111012005 DEM Plumbing Groundwork Pass 0211812005 DEM Framing Fail D2t1812005 DEM Electrical Rough -ins Fail 02/1812005 DEM Mechanical Rough-ins Fail 0211812005 DEM Plumbing Rough -ins Fait M95r2005 DEep Framing Fafi t_ City of Blair Building Permit Detail 0212512005 DEM Electrical Rough -ins Fail 0212512005 DEM Mechanical RoughAns Fail 02125/2005 DEM Plumbing Rough -ins Fail 031012605 DEM Mechanical Rough-ins Pass 03/0112005 DEM Electrical Rough -ins Pass 03/01/2005 DEM PlumbingRough4ris Pass 03101/2005 DEM Plumbing Pressure Test Pass 03/01/2665 DEM Framing Pass 0310412005 DEM Septic - Laterals & Drainfields Pass 03/0412005 DEM Water Service Pass 03706/2005 BRT Stop Box Card Pass MM2005 DEM Electrical Permanent Service Pass 061022005 DEM Final Inspection of Project Fail 06/02/2005 DEM Electrical Final Pass 0610212005 DEM Mechanical Final Pass 061622005 DEM Plumbing Final Pass 061362005 DEM Final Inspection of Project Pass BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska Permit Fee: CD 218 South 16th Street Issuance Fee: I w / ZcX cu Blair, Nebraska 68008 11713 Receipt #: 6 •x(402) 426 -4191 • Fax (402) 426 -4195 Permit Deposit Receipt #: IL. K3 � f'` Issue Date: 1 61 (0) 01-- Type: K)i IAi �t' ousc+ JOB ADDRESS 36 , LEGAL 1.DESCfl. NOGW1C.. 3 C)w1C_ Pckt`M1z-.. t ❑SEE ATTACHED SHEET ER MAIL ADDRESS ZIP WORMELL PHONE `>_{a"'"I"1'"1 2. ul�r� cu - cl CONTRACTOR MAIL ADDRESS ZIP HOME PHONE 3 tn ( o V 4.1 +c1 -A S Yl'1 5 a 2& L n'in -itc , ( [ f �l WORKJCELL PHONE 4. Class of Work: Q NEW Q ADDITION Q REMODEL q OTHER Q FINISHED BASEMENT P1 UNFINISHED BASEMENT 5. Describe work: ( /A • h K } ( jLt 3 Crux ( ara 11exF kc �i d A r Ci K a0w B' oFF ey- Vvund OW cl it i b-od r 1- 2 M 54 .PF 6. Valuation of Work: $ �(X)� Total Sq. Footage (Including Basement and G=ge)3q Z 3 Total Finished Area: (p Z Z Floodway O Yes O No Dev. Pcamit Bev. Ced. 7. Floodplain: Fringe O Yes Cl No BFE 8. Current Zoning: o Q Site Plan Attached Q Complete Plans Attached Approximate Completion Date f " 30 uT 9. State Fire Marshall Required: Q Yes g No Inspections Required and Fees 10. Special Use Permit Required: Q Yes No Utiliti 11. Variance Required: [3 Yes [(Vo Sewer Wate erCce 12. Minimum Setbacks: Front 2 . Side 7 Rear � S is �mrte 13. Sidewalk Required: Q Yes KNo Waiver Approved Shop Box Ca d Buildma NOTICE F ngs D Separate permits are required for electrical, plumbing, heating, ventilating and air (� PRIOR TO TAPING) conditioning, and septicsystems. By mysignaturebelow, I acknowledgethat payment of the building permit application tee does not constitute issuance of this building Fr -.F permit. I further agree that construction covered by this permitappiication shall not be commenced until I have received acopyofthis application form signed bytheBuilding Electrical 7t)c Ln Lt5t3fY1C S �L2[ F Inspector. — I hereby agree to performthe proposedwork in accordance With the specificationsset in F' res forth above and in accordance with the codeslordinances of the City of Blair and the Stateof Nebraska. I understand thatthis permit isvoidif work is not commenced within a nentService 1 By s o is no ornpleted within 2 years of date of issue. Temp service G 0 h nic VM �Yl Yy� y' St S{P Vh S GNATURE OWNERrCO ACTOR DATE I -- Ro Comment: T�i4'fa " �j ° I t64 F' O ply Ll�li x� t 4 c) min C� C�ln MEEtI8C. IRC ,IPC,IMCANDNECCODEREQUIREMENTS drt SLEEPING ROOMS BELOW THE FOURTH R REQUIRED TO N VEAN EGRESS WINp011� WHEN PROPERLY VALID T D (IN THIS SPACE TH RMIT A PDUNDePMG. Blab. NE eev.eN6 PLUMBING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 1 222 Fax (402) 426 -4195 P (402) 426 -4191 1 1 713 Application Date: , 3 Y 7 o5 Permit Fee: JOBADDRESS t _. �) 2 � / pi c, ' OWNER MAILADDRESS ZIP PHN 1. lZlL� ll�%IL�- OE 9Ura , /� .2-77?J� TRACT MAIL ADDRESS PHO LICENSE NO. 2 .i� Tre t chin 'R r/ J Av <- �� � 67 - , 3. Class of Work: O COMMERCIAL ESIDENTIAL NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT 4. Describe Work: 40 i� ' �Lr1Ca a A)a e� Comments: GG PLUMBING PERMIT FEES Modular Home ...................... $15.00 Type of Fixture No. Kitchen ........ ..........................$8.00 x Bath... .................................... $8.00 x Rough -In Bath ....................... $4.00 x Slop Sink/Laundry Tray.. ....... $5.00 x Water Heater.... ... ............ $3.00 x Outside Water Faucet ........... $3.00 x Drinking Fountain ..................$3.00 x Water Service ........................$10.00 t ld'UU NOTICE Sewer ..... ............................... $10.00 1 hereby certify that I have read and examined this Groundwork .. .........................$10.00 application and know the same to be true and correct. All provisions of laws and ordinances governing this type of Septic Tank & Laterals ..........$10.00 work will be complied with whether specified herein or not. Lawn Sprinkler System .........$10.00 The granting of a permit does t presume to give authority to violate or cancel theprovisi sofan other state or local Sprinkler System ...................$30.00 law regulating con tructi n or th p rformance of construction. (Commercial) Gas/Water Piping System (Commercial) ............................ $30.00 1 Permit Issuance Fee .............$15.00 SIGNATURE OF NTRA 0 THORIZED AGENT ^� i TOTAL DATE Current License on File Xes O No O NA WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approve y: POUNDS PPTG.06i¢ NE Aq 4180 i PLUMBING PERMIT APPLICATION j Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426 -4195 P 1193 (402) 426 -4191 Application Date: �' 61 Permit Fee: $ U0 JOBAy��DDDRRESS Q Eck, �1 �} 7 7 I ,, y 001 (} �j Y E st a MAI JDDR / U.--' O MA j. V O 13 `1 (,Lt 1. O PjH W — �ONE, ,22J 2 NTR 0 R F � ADD ESS n PHONE LICENSE NO. 3. Class of Work: O COMMERCIAL ESIDENTIAL NEW 1/ 0 ADDITION O ALTERATION O REPAIR 1J O REPLACEMENT 4• Describe Work: Comments: PLUMBING PERMIT FEES r� �I, 1 3 Modular Home ...................... $15.00 (� Type of Fixture No. Kitchen ... ............................... $8.00 x , ul� Bath ........ ............................... $8.00 x 3 y GO Rough -In Bath .......................$4.00 x t Slop Sink/Laundry Tray ......... $5.00 x `� - U J Water Heater ............. $3.00 x yo Outside Water Faucet ........... $3.00 x 3 OLJ Drinking Fountain ..................$3.00 x Water Service ........................$10.00 NOTICE Sewer ..... ............................... $10.00 I hereby certify that I have read and examined this Groundwork .. .........................$10.00 UJ application and know the same to be true and correct. All provisions of laws and ordinances governing this type of Septic Tank & Laterals ..........$10.00 work will be complied with whether specified herein or not. Lawn Sprinkler System ......... $10.00 The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local Sprinkler System ...................$30.00 law regulating construction or the performance of (Commercial) construction. Gas/Water Piping System ( Commercial) ... .........................$30.00 Permit Issuance Fee .............$15.00 / SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT TOTAL DATE Current License on File Yes O No O NA WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: iI POUNDS PRTp- ftir. NE R.,4M MECHANICAL PERMIT APPLICATION j Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426 -4195 M 1126 (402) 426 -4191 Application Date: (o ( ( 0 ``' Permit Fee: $ tea ,SOB ADDRESS L c�4 y t, 3 riL ,) WNER MAIL ADDRESS ZIP PHONE r d s � n� . Urnal2a e to t3 `I Spa - - I - - I � � o e NTRACT MAIL ADDRESS PHONE LICENSE NO. 2 ' l rev" OR Q_L St T U1 q� - o. = 0t �) a -1 3. Class of Work: 11 COMMERCIAL P RESIDENTIAL -n NEW 0 ADDITION O ALTERATION O REPAIR 0 REPLACEMENT 4• Describe Work: IVI echon 1L3 A� y p er mr { riff V4 60 -e--- Central A/C 3 Tons MECHANICAL PERMIT FEES �Z I WO Forced Air /Heat Pump S 2 S •bC� Furnace BTU /H P stems - Per Unit Y Commercial /Residential ( New) .................................................... $25.00 # of Units A/C Air - Conditioner Unit - Per Unit 10.0o Furnace Commercial /Residential (New) ..................... ............................... $10.00 Forced Air Systems /Air Conditioner Completion Date: Unit Replacement Per Unit Commorcial/Residential ................... $10.00 Refrigeration Units /Coolers /Lines /Compressor - Comments: Per Unit Commercial (New or Replacement) ...... ..................... $10.00 K-e ILA Inc— a—in C— Appliance Vent/Fans ...... .........................$10.00 !O •00 Boiler .............................. ......................... $15.00 Duct System ................... ......................... $10.00 (O. v- Gas/Air Outlets., ..... .......... x $2.00 NOTICE Radiant Heat Systems ... .........................$25.00 I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Modular Home .......... ............................... $15.00 The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local l5 , OL7 law regulating construction or the performance of Permit Issuance Fee ............................... $15.00 construction. /j 62L_ TOTAL _16 ADO a � E« = 'SiGNATURE OF ONTRACTOR OR AUTHORIZED AGENT Current License on File gY'es 0 No 0 NA .a DATE WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: / �.0 Y POUNOS PATE: Blair. NE gay.6138 ELECTRICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426 -4191 Permit E 2 089, l n ►r rI � Application Date: / � d Permit Fee: $ JOB ADDRESS - r,� LEGAL 1- DESCR. J �/ rk fQ d 3 O SEE ATTACHED SHEET OWNER MAIL DORESS �Q ZIP _ yy0RK10ELL PHONE /f- •" / I / 2 ' U Q a r �U� u HOMEPHONE 3 COMRACTOR'/ // C q MAILADDR / .,f PHONE t�e� HOME PHONE - AZ 0Z F/v 7"/fiQ7 G�& �Qle- ,Q, J ' „r Zjjl RKJCELL PHONE (f 4• Class of Work: NEW RESIDENTIAL O NEW COMMERCIAL p REMODELINGlADDITIONS p UPGRADE SERVICE 5. Describe Work: Z7 `-E6rrA O� 6W 0 6. Current License on File IgYes O No O NA Completion Date New Service Fee = (Amp Fee + $2,00 per branch circuit) ELECTRICAL PERMIT FEES 1 -100 Amp Fee.... .. ....................... $ 13.00 Upgrade Existing Service ...... $10.00 101 -200 Amp Fee ...............:............$ 18.00 Temporary Service .. .............. $10.00 G49 201 -300 Amp Fee .... ........................$30.00 Fire Alarm System ............ ..... $10.00 301 -400 Amp Fee ............................ $ 42.00 401 -500 Amp Fee ............................ $ 55.00 Signs.. .... ............................... $15.00 501 -600 Amp Fee .... ........................$67.00 Miscellaneous Apparatus ...... $11.00 601 -700 Amp Fee ............................ $ 80.00 AC /DC Circuit........................ $5.00 701 -800 Amp Fee ............................ $ 92.00 Commercial/Multi-Family and All Upgrades: 801 -900 Amp Fee ............................ $105.00 Y p9 901 -1000 Amp ..... ..... ... .... - .... ..... ..... $117.00 # of Circuits x $2.00 IF OVER 1000 Amp Amp Fee 1st 1000 Amp Fee ....................... $117.00 Each additional 100 Amps ., .... .....$ 13.00 Amp Fee + Circuit Total New Residential: (Finished Area) NOTICE Singl Family Dwellings q Gj I hereby certify that I have read and examined this /&Z1 sq. ft. x .045 r application and know the same to be true and correct, All provisions of laws and ordinances governing this type of Modular /Manufactured Homes ....... $30.00 work will be complied with whether specified herein or not. The granting of a permit does notpresumeto give authority Receptacle /Switch Outlets to violate or cancel the provisions of any other state or local Fixtures -x $75 law regulating construction or the performance of Smoke Detectors x $3.00 construction. Residential /Commercial Appliance # Fixed Outlets x $3.00 Motor(s) x $3.00 a� Power Apparatus (220 Volts) SIGNATURE OF CON RACTOR OR AU HORIZED AGENT # Apparatus x $3.00 — 13 Permit Issuance Fee ............. $15.00 a 0 DATE TOTAL WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: �' �' d POUNDS PRTG: BIai, NE R prgg BUILDING INSPECTION REPORT ❑ CITY OFBLAIR ❑ WASHINGTON COUNTY y ❑ OTHER ��ii LOCATIONOFINSPECTION ( Lcl! 7 )II` ocu -.A I L 1 Il.?�� CL �f � NAME OFOWNER' e {,L C / Cr clac!'CY CONTRACTO R LI N-311 ILI n C1 TIME INSPECTION REQUESTE lr dU 7'JI PERMIT NO DATE INSPECTION REQUESTED --- = 1() S � / TYPE OF INSPECTION REQUESTED: ','�E T ❑ CONFERENCE ❑STATUS CHECK BUILDING: ❑ FOOTING ❑ DECKFOOTING ❑ FRAMING ❑ DRYWALL FINAL ❑ PARTIAL PASS FAILED COMMENTS: - G�/ ��� _ ❑ UTILITIES: ❑ SEWERTAP ❑ SEWER ❑ SEPTIC ❑ WATERTAP ❑ REMOTE ❑ WATERSERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FABLED ❑ PARTIAL. ❑ ❑ COMMENTS: MECHANICAL:❑ ROUGH -IN ❑ AIC ❑ FURNACE ❑ RADIANTHEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL. ❑ WATERMETERINSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TFST ❑ ❑ COMMENTS: i ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS - INSPE DATE OF INSPECTION MADE: ° -- FAXED OPPDIBURT REA TO CONNECT SERVICE: ON - BY " BUILDING INSPECTION REPORT 1/I CPI'YOFBLAIR ❑ WASHINGTON COUNTY El OTHE � ff LOCATION OFTNSPECTION 11 o ' { ` ',_ � io� NAMEOFOWNER ? CONTRACTO -DATE INSPECTION REQUESTED L_2_ TIME INSPECTION REQUESTED : J PERMIT NO A TYPE OF INSPECTION REQUE � . ❑ CONFERENCE ❑ STATUS CHECK BUILDING: F1 FOOTING El DECKFOOTING El FRAMING ❑ DRYWALL �p FINAL ❑ PARTIAL PRSS FAIL COMMENTS / UTILITIES: ❑ SEWERTAP ❑ SEWER ❑ SEPTIC ❑ WATERTAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED _ ❑ PARTIAL - ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGHIN7f FINAL ❑ PERMANENT SERVICE ❑TEMPORARY SERVICE ❑. PRECONNECT PASS FAILED . 1 PARTIA ❑ COMMENTS: MECHANICAL:❑ ROUGH-IN 'D AJC ❑ FURNACE ❑ 1RADIANTHEAT KFINAL ❑ PARTIAL PASSV FAILED El COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN FINAL ❑ WATER METER INSTALLED ❑ PARTIAL. PASS FAILED COMMENTS; El PRESSURE TEST El ❑ OCCUPANCY GRANTED CONDIT AL OCCUPANCY GR ED NOT S/REMARK !P INSP DATE OF INSPECTION MADE: TIM FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY f'SIJILDING INSPECTION REPORT ❑ CITY OF BLAD2 WASHINGTON COUNTY El OTHER LOCATION OF INSPECTION: NAMEOFOWNER: fa'�iGL.( +id? P'r- 1'c7�= >m¢'% CONTRACTOR: %Z DATE INSPECTION REQUESTED: �, ee TIMEINSPECTIONRPQUESTF.D: `�` � PERMITNO: // ; TYPE OF INSPECTION ESTER: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: y „FOOTDa� j G / ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL P`Al,SyS�FP,, FAILED COMMENTS: El _{ UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑WATER SERVICE PASSED - FAILED ❑ PARTIAL ❑ ❑ . COMMENTS: ELECTRICAL: ❑ ROUGH IN [ FINAL ❑PERMANENT SERVICE ❑TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED _...;� ❑ PARTIAL ❑ F] ,: ;, COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A1C ❑ FURNACE ❑ RADIANTHEAT ❑FINAL ❑PARTIAL .PASSED FAILED COMMENTS: El El PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED El PARTIAL PASSED FAILED ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: INSPECTOR; - -:_ —..._ DATE OF INSPECTION MADE: I�t ----.- TTME; ".�" " FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY 1 BUILDING INSPECTION REPORT ,❑ CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHE } LOCATION OF INSPECTION NAME OFOWNER CONTRACTO - " - DATE INSPECTION REQUESTED t C�� - ' TIME INSPECTION REQUESTED A i R v 1 PERMIT N0. TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK. BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: - UTILITIES: [ SEWERTAP ❑ SEWER ❑ SEPTIC ❑ WATERTAP ❑ REMOTE ❑ WATERSERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE TEMPORARY SERVICE El PRECONNECT PASS FAILED COMMENTS: F] PARTIAL ❑ Lt (I C l aJ^ MECHANICAL: [I ROUGH -IN ❑ A/C ❑ FURNACE El RADIANT BEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑. GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ - PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS` INSPECTOR- DATE OF INSPECTION MADE: f 1'BvIE �-i` ° r I FAXED OPPDIBURTREA O CONNECT SERVICE: ON BY r BUILDING INSPECTION REPORT CITY OF BLAIR ❑ WASHINGTON } COUNTY ❑ OTHER— LOCATION OF INSPECTION /Gt Ay NAME OF OWNER �'`&d..C�iJt!/1r CONTRACTO #' t��'�. -' DATE INSPECTION REQUESTE • 1 a � �-� TIME INSPECTION REQUESTED = ¢ ' PERMIT NO !/ 6 1 TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL _ PASSED FAILED COMMENTS: UTILITIES: ❑ SEWERTAP ❑ SEWER ❑ SEPTIC ❑ WATERTAP ❑ REMOTE ❑ WATERSERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL:❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANTHEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: GROUNDWORK r FINAL El WATER METER INSTALLED El PARTIAL PASSED FAILED El T PRESSURETE S ❑ COMMENTS: ❑ OCCUPANCY GRANT ❑ CONDITIONAL OCCUPANCY GRANTED NOTES. S• L[L �la`�'/ S fL% �1��� /2F.•' INSPECTO DATE OF INSPECTION MADE: FAXED OPPIABURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR ❑ WASHINGTON COUNTY El {} j ❑ p, O'THE R � LOCATION OF INSPECTION F >' 1 \`J�"U`�`'`(Y.✓L1 I ' NAMEOFOWNER I�t�'t- °- �L.�-''UJ CONTRACTO - 2 �f } DATE INSPECTION REQUESTED � � r x ; 'CIiv1E INSPECTION REQUESTED F � ' � t � PERMTT NO Ij ' 2 �-') TYPE OF INSPECTION REQUES ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECKFOOTING 94RAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED- FAILED t ❑ d COMMENTS: UTILITIES: ❑ SEWERTAP ❑ SEWER ❑ SEPTIC ❑ WATER.TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ® ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED P ❑ PARTIAL ❑ V�J COMMENTS: MECHANICAL: ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HFAT ❑ FINAL ❑ PARTIAL PASSED F�D Li COMMENTS: ATt�ED COMMENTS: "PLUMBING: F1 GROUNDWORK ROUGH -IN FINAL ❑ WATERMET'ERINSTALLED ❑ PARTIAL PASSED F` 1-1 PRESSURE TE El ❑ OCCUPANCY GRANTED f ❑ CONDITION OCCUPANCY /,� G GR RRA � N J `TED �/` NOTES/REMARKS ( / �&_ / 1 �""'� f '' " " 9-A LRC ht - : &�i t 7p �' LA� Y f INSPECT ATE OF INSPECTION MADE: Tm. .FAXED OPPDIBURT REA TO CONNECT SERVICE: ON BX BUILDING INSPECTION REPORT 11j CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHE LOCATION OF INSPECTION /03l`E��4 - NAMEOFOWNER r'r'jLP.P' -'� `<�tp !(1 /,�lf(f CONTRACTO DATE INSPECTION REQUESTED ` '� " �} I TIME INSPECTION REQUESTED 1 11 1 „ PERMIT TYPE OF INSPECTION REQUESTED: ❑ 46NFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECKFOOTING r\] ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAD.$D COMMENTS: A ❑ Y r J A UTILITIES: ❑. SEWERTAP ❑ SEWER ❑ SEPTIC ❑ WATERTAP ❑ REMOTE ❑ WATERSERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAII,FD PARTIAL ❑ COMMENTS: MECHANICAL: V ROUGH -IN ❑ AIC ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAIL COMMENTS: r El PLUMBING: ❑ GROUNDWORK ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL, PASSED FAILED C OMMENTS: El PRESSURE TEST ❑ Y n J (' ❑ OCCUPANCY GRANTED ❑ CONDITIONALOCCUPANCY GRANTED f N07'EStREMARKS � ,/ �`I ..f/ i - .. L 04 cJf t T6 o- LZzS' C o e, / 8a INSP TE.OF INSPECTION MADE: EY} TIM + +'► FAXED OPPDiBURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR ❑ WASHINGTON COUNTY ❑(/j� OTHE tI LOCATION OF INSPECTION NAME OF OWNER CONTRALTO DATE INSPECTION REQUESTED �2 TIME INSPECTION REQUESTE PERMIT NO f TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: FOOTING ❑ DECKFOOTING FRAMING ❑ DRYWALL ❑ FINALE] PARTIAL PASS COMMENTS: ❑ UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: , ,,� ELECTRICAL,,U ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASS D FAILED COMMENTS: ❑ PARTIAL ❑ - MECHANICAI ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PAD FAILED El COMMENTS: PLUMBING: ❑{ GROUNDWORK, ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED VI PRESSURE TEST ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITI OCCUPANCY GRANTED NOTES/REMARKS f INIMCT& OF INSPECTION MAD _ _.. T IME: y FAXED OPPDIBURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHE LOCATION OF INSEECHOM - 7 7 73 NAME OF OWNER: CONTRACTOR- DATE INSPECTION REQUESTED TIME INSPECTION REQUESTED- PERMITNO�_�' TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING [ FRAMING ❑ DRYWALL ❑ FINAL PARTIAL PASSED FAILED F-1 ❑ COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED COMMENTS: ❑ PARTIAL ELECTRICAL: ❑ ROUGH IND FINAL X PERMANENT SERVICE E_1 TEMPORARY SERVICED PRECONNECT FAILED ❑ IL PA , COMMENTS: El MECHANICAL: ❑ ROUGH-IN ❑ A/C ❑ FURNACE ❑ RADiANTHEAT [__1 FINAL ❑ PARTIAL PASSED FAILED. ❑ COMMENTS: El PLUMBING: ❑ GROUNDWORK E] ROUGH-IN ❑ FINAL WATER METERiNsTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS INSPECTCt� DATE OF INSPECTION MADE: TIME— FAXEDOPPD\B TREA TO CONNECT SERVICE: ON B WARNING: THIS DRAWING CANNOT BE LEGALLY USED TO INSTALLAFENCE OR ANY OTHER STRUCTURE ON THIS PROPERTY, AND IS NOT INTENDED TO BE A LAND SURVEY AS DEFINED BY STATE STATUTES. �` +h ✓¢�� (I6 d 0 15 30 Scale: 1" = 30' 159.23' N '^ N cY � s S4 �" C� N 4 �.3' 4jO V W N, o Wo v CIO 0 w a- I 1 CO co 11 8.51 , SQUARE FOOTAGE ZONING R•L LOT: 23,205 S.F. FRONT: 25 FT. HOUSE: 2,391 S.F. REAR: 25 FT. CONCRETE: 979 S.F. SIDE: 9 FT. DECK: 390 S.F. Q E &A CONSULTING GROUP RS PLOT PLAN ENGINEERS •PLANNERS •SURVEYORS M, Qsudv dh x m w", IhOK 424.w% LOT 4, BLOCK 3, Drawn by: DSH CIhkdby: 11- 2z -o•f Chkaby: OAK PARK FIRST ADDITION Job ' NO.:2004220.01 Date: 11122104 WASHINGTON COUNTY, NEBRASKA K :1Projects12004t226ipg1lSn7 bt PlanslLOT 4, SLK, 3, OAK PARK 1S7 AMWO.dwg, 8,5x14,111221203410:38:35 AM, Cough pppl m r 1 I.w. Y U J � z✓ ,l 55 PI" - -7 A19 8; 49. AGREEMENT eur�srrrt rer_, =�tE This Agreement made this day of�cs� 2065 by and betweenhe City of Blair, Nebraska, hereinafter referred to as "Blair', and 6tv ( gr oSo- a , hereinafter referred to as "Customer'. WITNESSETH: Whereas, Customer has made a request to Blair and hereby makes application for -rntF- water from within the municipality, said water to be utilized at Customer's personal residence, which is located on the following described real estate, to -wit: Whereas, under the terms and conditions as set forth herein, Blair is willing to sell Customer city water. NOW, THEREFORE, BE IT AGREED by and between the parties that for and in consideration of One Dollar and mutual benefits to be derived by both parties hereto, the specific receipt thereof being hereby acknowledged, it is agreed as follows: 1. Customer shall be allowed to purchase water from Blair at a place to be designated by the Director of Public Works of Blair. Prior to installation of the meter and tap, Customer shall submit to the City of Blair plans and specifications acceptable to Blair for such tap and such tap shall be made in accordance with all plans, specifications, and requirements of Blair. Such specifications and requirements shall include but not be limited to the installation of a back flow preventer. Such tap shall be such size as required by Blair and the Customer shall pay for all supplies and materials, except for the water meter. Customer shall notify Blair, prior to commencement of construction and at 57 (25) years from the date hereof. 5. The charges by Blair to Customer for water provided may be adjusted from time to time by the Mayor and City Council of Blair. The Customer shall also be subject to all other rules and regulations of the City of Blair as pertains to its customers of the municipal water system, including but not limited to payment, deposit, and shut off regulations. 6. This agreement shall be binding upon the heirs, personal representatives; successors, and assigns of Customer. This agreement shall also'sp�ctfically run with the land with respect to the real estate described hereinabove and shall be binding upon all grantees, assignees, and subsequent owners of such real estate. The Customer shall be responsible for and shall file a copy of this agreement against said read estate in the office of the County Clerk of Washington County, Nebraska, prior to Blair's providing water service to the premises. CITY OF BLAIR, NEBRASKA BY JaRealph, Mayor ATTEST: `g Bfd n - da Wheeler, City Clerk �GLi SCYi�la 3 ,' I ' STATE OF NEBRASKA COUNTY OF wASHINGTON)SS � ENTER�DINNUMERICAL INDEX AND FILED FOR RECORD stomer PHIS tH-) DAY OF 'n2a&Lh t A.D. 20-2- AT_t 2 - 'CLOC K 1 7 1] 5 ANR GORDEDINBOOK ±F_S R A T PA ) COUNTY CLERK ° 1 �/ Address r)FPLa d - fo0` /- 3116 General Numerical Photostat .I 0 Proofed --- CITY Of UAIQ ti br ° fiise of June 3, 2005 Paul Bruseaard 5801 N. 90 Street Omaha, NE 68134 RE: Final inspection of Building Permit #11713 11302 Rambleddge Drive, Blair, NE 68008 Dear Mr. Brusegaard, On June 2, 2005 Dale Miller did a final inspection at the above location which failed. Enclosed is a copy of the inspection report for your reference. Please note that this project must be completed for a re- inspection on or before Tuesday, July 5, 2005 in order for your $200.00 deposit to be refunded. If you have any questions, feel free to contact either Dale or myself. Thank you in advance for your cooperation in this matter. Sincerely, /�X Brenda Wheeler City Clerk Enc 218 South 16th Street - Blair, Nebraska 68008 • 402 -426 -4191 • Fax 402 - 426 -4195 • E-mail citvofblair @ci.blair.ne.us City of Blair 218 South 16'" Street Blair, NE 68008 Voice (402) 426 -4191 Fax (402) 426 -4195 a F kx ` r ymise 0 To: D. a CA From: Fax: Pages: Phone: Date: Re: CC: Q Urgent ❑ For Review O Please Comment ❑ Please Reply ❑ Please Recycle • Comments% �� - L OL , BUILDING PERMIT REVIEW OWNER: Paul Brusegaard PERMIT NO. 11713 BUILDER: Enviromental Systems CLASS OF WORK: NEW RESIDENTIAL: X ADDITION: NEW COMMERCIAL: GARAGE: REMODEL: TOTAL SQUARE FOOTAGE: MAIN: 1622 sq. ft. SECOND FLOOR: BASEMENT: 1542 sq. ft. SUNROOM: GARAGE: 674 sq. ft. TOTAL FINISHED AREA: 1622 sq. ft. NUMBER OF BEDROOMS: 2 EMERGENCY EGRESS: Egress windows required in all sleeping rooms and basement. DECK: Attached Deck on Rear. PLUMBING FIXTURES: KITCHEN: yes BATH: 2 ROUGH -IN BATH: I (Basement) UTILITY: gas, electric, water & sewer WATER HEATER: gas OUTSIDE FAUCET: 2 HEATING FIXTURES: FURNACE: gas A/C: yes SITE REVIEW: D. Miller CURRENT ZONING: RL 1. LOCATION ON LOT (SETBACKS) A. FRONT YARD REQUIRED: 25' SHOWN: 28'2" B. REAR YARD REQUIRED: 25' SHOWN: 26' C. SIDE YARD REQUIRED: 7' SHOWN: 61' 2. LOT AREA REQUIRED: 6,000 sq. ft. ACTUAL: 25,684 3, LOT COVERAGE ALLOWED: 40% ACTUAL: 8% Plans Reviewed: Dale Miller Date: November 1, 2004 C ITY Of U i� aro /se of BUILDING PERMIT SUPPORTING DOCUMENTS This building permit packet includes various items dealing with particular code requirements and/or building permit requirements. It in no way includes ALL particular code items. Also, it is your responsibility to know the 2003 International Building Code requirements that apply to your project. Please understand this packet is only designed and distributed to aid you in your building permit process. A copy of the International Building Code is available for your use at the Blair Public Library. I have read the above disclosure and accept this building permit documentation on my own behalf assuming full responsibility as the owner /contractor for this project. I ( 2zj �Z� 4 e__ r _ Owner /Occupant Contractor City of Blair Date 218 South 16th Street • Blair, Nebraska 68008 • 402- 426 -4191 • Fax 402 -426 -4195 • E -mail cityofblairphuntel.net ,N„m Re- (P130 los v* 6 City of Blair Building Permit Detail Permit #: 11713 Issued: 1 010 6/20 0 4 Type: Residential - New Construction Completed: 06/30/2005 Valuation: 150000 Location: 11302 Rambieridge Dr Owner: Paul Brusegaard Permit Fee: 675 Address: 5801 N. 90th Street Issue Fee: 15 Deposit Amt.: 200 Omaha, NE 68134 Receipt #: 12823 Phone: 402 572 7773 Section: Township: Range: Subdivision: OAK PARK I Lot: 4 Block: 3 Ranch -2 bedroom, unfinished walkout basement; 3 car attache garage next to utility room; deck in rear approximately IT off of ground off kitchen and bathroom; lot 25,684 sq. ft.; 3923 total sq. ft.; 1622 finished area Contractors Environmental Systems Service, Inc. General Contractor Permit # Issued Century Electric, Inc. Electrical Subcontractor E2089 12/1012004 Environmental Systems Service, Inc. Heating Subcontractor M1126 10/0612004 Haman Trenching, Inc. Plumbing Subcontractor P1222 0310412005 Redden Plumbing Plumbing Subcontractor P1193 12/22/2004 Remarks 011102005 DEM Building site requires a sift fence installed to prevent dirt from falling into ditch or affecting county road. 02!182005 DEM All inspection on hold unfit such time as teh sift fence is installed to prevent dirt or mud from going into the ditch. 02252005 DEM Exhaust shall vent directly to outside. Exterior basement shall wiring as required by code for finished wall (switches and recp.'s) Pressure test on plumbing. #100 water and #5 sewer. 08102/2005 DEM Deck rails not complete cover underside of stairs address for house not installed. Inspections Date By 11)242004 KAR Footings Pass 1211312004 DEM Electrical Temporary Service Pass 0111012005 DEM Plumbing Groundwork Pass 0211812005 DEM Framing Fail D2t1812005 DEM Electrical Rough -ins Fail 02/1812005 DEM Mechanical Rough-ins Fail 0211812005 DEM Plumbing Rough -ins Fait M95r2005 DEep Framing Fafi t_ City of Blair Building Permit Detail 0212512005 DEM Electrical Rough -ins Fail 0212512005 DEM Mechanical RoughAns Fail 02125/2005 DEM Plumbing Rough -ins Fail 031012605 DEM Mechanical Rough-ins Pass 03/0112005 DEM Electrical Rough -ins Pass 03/01/2005 DEM PlumbingRough4ris Pass 03101/2005 DEM Plumbing Pressure Test Pass 03/01/2665 DEM Framing Pass 0310412005 DEM Septic - Laterals & Drainfields Pass 03/0412005 DEM Water Service Pass 03706/2005 BRT Stop Box Card Pass MM2005 DEM Electrical Permanent Service Pass 061022005 DEM Final Inspection of Project Fail 06/02/2005 DEM Electrical Final Pass 0610212005 DEM Mechanical Final Pass 061622005 DEM Plumbing Final Pass 061362005 DEM Final Inspection of Project Pass BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska Permit Fee: CD 218 South 16th Street Issuance Fee: I w / ZcX cu Blair, Nebraska 68008 11713 Receipt #: 6 •x(402) 426 -4191 • Fax (402) 426 -4195 Permit Deposit Receipt #: IL. K3 � f'` Issue Date: 1 61 (0) 01-- Type: K)i IAi �t' ousc+ JOB ADDRESS 36 , LEGAL 1.DESCfl. NOGW1C.. 3 C)w1C_ Pckt`M1z-.. t ❑SEE ATTACHED SHEET ER MAIL ADDRESS ZIP WORMELL PHONE `>_{a"'"I"1'"1 2. ul�r� cu - cl CONTRACTOR MAIL ADDRESS ZIP HOME PHONE 3 tn ( o V 4.1 +c1 -A S Yl'1 5 a 2& L n'in -itc , ( [ f �l WORKJCELL PHONE 4. Class of Work: Q NEW Q ADDITION Q REMODEL q OTHER Q FINISHED BASEMENT P1 UNFINISHED BASEMENT 5. Describe work: ( /A • h K } ( jLt 3 Crux ( ara 11exF kc �i d A r Ci K a0w B' oFF ey- Vvund OW cl it i b-od r 1- 2 M 54 .PF 6. Valuation of Work: $ �(X)� Total Sq. Footage (Including Basement and G=ge)3q Z 3 Total Finished Area: (p Z Z Floodway O Yes O No Dev. Pcamit Bev. Ced. 7. Floodplain: Fringe O Yes Cl No BFE 8. Current Zoning: o Q Site Plan Attached Q Complete Plans Attached Approximate Completion Date f " 30 uT 9. State Fire Marshall Required: Q Yes g No Inspections Required and Fees 10. Special Use Permit Required: Q Yes No Utiliti 11. Variance Required: [3 Yes [(Vo Sewer Wate erCce 12. Minimum Setbacks: Front 2 . Side 7 Rear � S is �mrte 13. Sidewalk Required: Q Yes KNo Waiver Approved Shop Box Ca d Buildma NOTICE F ngs D Separate permits are required for electrical, plumbing, heating, ventilating and air (� PRIOR TO TAPING) conditioning, and septicsystems. By mysignaturebelow, I acknowledgethat payment of the building permit application tee does not constitute issuance of this building Fr -.F permit. I further agree that construction covered by this permitappiication shall not be commenced until I have received acopyofthis application form signed bytheBuilding Electrical 7t)c Ln Lt5t3fY1C S �L2[ F Inspector. — I hereby agree to performthe proposedwork in accordance With the specificationsset in F' res forth above and in accordance with the codeslordinances of the City of Blair and the Stateof Nebraska. I understand thatthis permit isvoidif work is not commenced within a nentService 1 By s o is no ornpleted within 2 years of date of issue. Temp service G 0 h nic VM �Yl Yy� y' St S{P Vh S GNATURE OWNERrCO ACTOR DATE I -- Ro Comment: T�i4'fa " �j ° I t64 F' O ply Ll�li x� t 4 c) min C� C�ln MEEtI8C. IRC ,IPC,IMCANDNECCODEREQUIREMENTS drt SLEEPING ROOMS BELOW THE FOURTH R REQUIRED TO N VEAN EGRESS WINp011� WHEN PROPERLY VALID T D (IN THIS SPACE TH RMIT A PDUNDePMG. Blab. NE eev.eN6 WARNING: THIS DRAWING CANNOT BE LEGALLY USED TO INSTALLAFENCE OR ANY OTHER STRUCTURE ON THIS PROPERTY, AND IS NOT INTENDED TO BE A LAND SURVEY AS DEFINED BY STATE STATUTES. �` +h ✓¢�� (I6 d 0 15 30 Scale: 1" = 30' 159.23' N '^ N cY � s S4 �" C� N 4 �.3' 4jO V W N, o Wo v CIO 0 w a- I 1 CO co 11 8.51 , SQUARE FOOTAGE ZONING R•L LOT: 23,205 S.F. FRONT: 25 FT. HOUSE: 2,391 S.F. REAR: 25 FT. CONCRETE: 979 S.F. SIDE: 9 FT. DECK: 390 S.F. Q E &A CONSULTING GROUP RS PLOT PLAN ENGINEERS •PLANNERS •SURVEYORS M, Qsudv dh x m w", IhOK 424.w% LOT 4, BLOCK 3, Drawn by: DSH CIhkdby: 11- 2z -o•f Chkaby: OAK PARK FIRST ADDITION Job ' NO.:2004220.01 Date: 11122104 WASHINGTON COUNTY, NEBRASKA K :1Projects12004t226ipg1lSn7 bt PlanslLOT 4, SLK, 3, OAK PARK 1S7 AMWO.dwg, 8,5x14,111221203410:38:35 AM, Cough pppl m r 1 I.w. Y U J � z✓ ,l 55 PI" - -7 A19 8; 49. AGREEMENT eur�srrrt rer_, =�tE This Agreement made this day of�cs� 2065 by and betweenhe City of Blair, Nebraska, hereinafter referred to as "Blair', and 6tv ( gr oSo- a , hereinafter referred to as "Customer'. WITNESSETH: Whereas, Customer has made a request to Blair and hereby makes application for -rntF- water from within the municipality, said water to be utilized at Customer's personal residence, which is located on the following described real estate, to -wit: Whereas, under the terms and conditions as set forth herein, Blair is willing to sell Customer city water. NOW, THEREFORE, BE IT AGREED by and between the parties that for and in consideration of One Dollar and mutual benefits to be derived by both parties hereto, the specific receipt thereof being hereby acknowledged, it is agreed as follows: 1. Customer shall be allowed to purchase water from Blair at a place to be designated by the Director of Public Works of Blair. Prior to installation of the meter and tap, Customer shall submit to the City of Blair plans and specifications acceptable to Blair for such tap and such tap shall be made in accordance with all plans, specifications, and requirements of Blair. Such specifications and requirements shall include but not be limited to the installation of a back flow preventer. Such tap shall be such size as required by Blair and the Customer shall pay for all supplies and materials, except for the water meter. Customer shall notify Blair, prior to commencement of construction and at 57 (25) years from the date hereof. 5. The charges by Blair to Customer for water provided may be adjusted from time to time by the Mayor and City Council of Blair. The Customer shall also be subject to all other rules and regulations of the City of Blair as pertains to its customers of the municipal water system, including but not limited to payment, deposit, and shut off regulations. 6. This agreement shall be binding upon the heirs, personal representatives; successors, and assigns of Customer. This agreement shall also'sp�ctfically run with the land with respect to the real estate described hereinabove and shall be binding upon all grantees, assignees, and subsequent owners of such real estate. The Customer shall be responsible for and shall file a copy of this agreement against said read estate in the office of the County Clerk of Washington County, Nebraska, prior to Blair's providing water service to the premises. CITY OF BLAIR, NEBRASKA BY JaRealph, Mayor ATTEST: `g Bfd n - da Wheeler, City Clerk �GLi SCYi�la 3 ,' I ' STATE OF NEBRASKA COUNTY OF wASHINGTON)SS � ENTER�DINNUMERICAL INDEX AND FILED FOR RECORD stomer PHIS tH-) DAY OF 'n2a&Lh t A.D. 20-2- AT_t 2 - 'CLOC K 1 7 1] 5 ANR GORDEDINBOOK ±F_S R A T PA ) COUNTY CLERK ° 1 �/ Address r)FPLa d - fo0` /- 3116 General Numerical Photostat .I 0 Proofed --- CITY Of UAIQ ti br ° fiise of June 3, 2005 Paul Bruseaard 5801 N. 90 Street Omaha, NE 68134 RE: Final inspection of Building Permit #11713 11302 Rambleddge Drive, Blair, NE 68008 Dear Mr. Brusegaard, On June 2, 2005 Dale Miller did a final inspection at the above location which failed. Enclosed is a copy of the inspection report for your reference. Please note that this project must be completed for a re- inspection on or before Tuesday, July 5, 2005 in order for your $200.00 deposit to be refunded. If you have any questions, feel free to contact either Dale or myself. Thank you in advance for your cooperation in this matter. Sincerely, /�X Brenda Wheeler City Clerk Enc 218 South 16th Street - Blair, Nebraska 68008 • 402 -426 -4191 • Fax 402 - 426 -4195 • E-mail citvofblair @ci.blair.ne.us City of Blair 218 South 16'" Street Blair, NE 68008 Voice (402) 426 -4191 Fax (402) 426 -4195 a F kx ` r ymise 0 To: D. a CA From: Fax: Pages: Phone: Date: Re: CC: Q Urgent ❑ For Review O Please Comment ❑ Please Reply ❑ Please Recycle • Comments% �� - L OL , BUILDING PERMIT REVIEW OWNER: Paul Brusegaard PERMIT NO. 11713 BUILDER: Enviromental Systems CLASS OF WORK: NEW RESIDENTIAL: X ADDITION: NEW COMMERCIAL: GARAGE: REMODEL: TOTAL SQUARE FOOTAGE: MAIN: 1622 sq. ft. SECOND FLOOR: BASEMENT: 1542 sq. ft. SUNROOM: GARAGE: 674 sq. ft. TOTAL FINISHED AREA: 1622 sq. ft. NUMBER OF BEDROOMS: 2 EMERGENCY EGRESS: Egress windows required in all sleeping rooms and basement. DECK: Attached Deck on Rear. PLUMBING FIXTURES: KITCHEN: yes BATH: 2 ROUGH -IN BATH: I (Basement) UTILITY: gas, electric, water & sewer WATER HEATER: gas OUTSIDE FAUCET: 2 HEATING FIXTURES: FURNACE: gas A/C: yes SITE REVIEW: D. Miller CURRENT ZONING: RL 1. LOCATION ON LOT (SETBACKS) A. FRONT YARD REQUIRED: 25' SHOWN: 28'2" B. REAR YARD REQUIRED: 25' SHOWN: 26' C. SIDE YARD REQUIRED: 7' SHOWN: 61' 2. LOT AREA REQUIRED: 6,000 sq. ft. ACTUAL: 25,684 3, LOT COVERAGE ALLOWED: 40% ACTUAL: 8% Plans Reviewed: Dale Miller Date: November 1, 2004 C ITY Of U i� aro /se of BUILDING PERMIT SUPPORTING DOCUMENTS This building permit packet includes various items dealing with particular code requirements and/or building permit requirements. It in no way includes ALL particular code items. Also, it is your responsibility to know the 2003 International Building Code requirements that apply to your project. Please understand this packet is only designed and distributed to aid you in your building permit process. A copy of the International Building Code is available for your use at the Blair Public Library. I have read the above disclosure and accept this building permit documentation on my own behalf assuming full responsibility as the owner /contractor for this project. I ( 2zj �Z� 4 e__ r _ Owner /Occupant Contractor City of Blair Date 218 South 16th Street • Blair, Nebraska 68008 • 402- 426 -4191 • Fax 402 -426 -4195 • E -mail cityofblairphuntel.net ,N„m - i x= CITY Of BtAIQ .. � of BUILDING PERMIT DEPOSIT AGREEMENT A $200.00 refundable deposit is being collected at the time of your building permit application for all permits $10,0000 and above. However, the City reserves the right to not refund this deposit if any of the following conditions occur during the construction period: 1) theft of water service by either the plumber, owner or general contractor, 2) all required inspections have not been obtained, 3) occupancy occurs prior to a final inspection, 4) all permits have not been obtained, and 5) the project is completed without a final inspection being done. If any or all of these situations occur during construction, you may forfeit your deposit. 1, hereby agree to the above conditions, and understand that should any or all of the above situations occur, the building permit deposit SHALL be forfeited or discounted upon the discretion of the City of Blair, Building and Inspections Department. ��� Contractor/C� ner Contractor /Owner City of Blair /©- Date 218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 -426 -4195 • E-mail cityofblalr @huntel.net a-=w Re- (P130 los v* 6 City of Blair Building Permit Detail Permit #: 11713 Issued: 1 010 6/20 0 4 Type: Residential - New Construction Completed: 06/30/2005 Valuation: 150000 Location: 11302 Rambieridge Dr Owner: Paul Brusegaard Permit Fee: 675 Address: 5801 N. 90th Street Issue Fee: 15 Deposit Amt.: 200 Omaha, NE 68134 Receipt #: 12823 Phone: 402 572 7773 Section: Township: Range: Subdivision: OAK PARK I Lot: 4 Block: 3 Ranch -2 bedroom, unfinished walkout basement; 3 car attache garage next to utility room; deck in rear approximately IT off of ground off kitchen and bathroom; lot 25,684 sq. ft.; 3923 total sq. ft.; 1622 finished area Contractors Environmental Systems Service, Inc. General Contractor Permit # Issued Century Electric, Inc. Electrical Subcontractor E2089 12/1012004 Environmental Systems Service, Inc. Heating Subcontractor M1126 10/0612004 Haman Trenching, Inc. Plumbing Subcontractor P1222 0310412005 Redden Plumbing Plumbing Subcontractor P1193 12/22/2004 Remarks 011102005 DEM Building site requires a sift fence installed to prevent dirt from falling into ditch or affecting county road. 02!182005 DEM All inspection on hold unfit such time as teh sift fence is installed to prevent dirt or mud from going into the ditch. 02252005 DEM Exhaust shall vent directly to outside. Exterior basement shall wiring as required by code for finished wall (switches and recp.'s) Pressure test on plumbing. #100 water and #5 sewer. 08102/2005 DEM Deck rails not complete cover underside of stairs address for house not installed. Inspections Date By 11)242004 KAR Footings Pass 1211312004 DEM Electrical Temporary Service Pass 0111012005 DEM Plumbing Groundwork Pass 0211812005 DEM Framing Fail D2t1812005 DEM Electrical Rough -ins Fail 02/1812005 DEM Mechanical Rough-ins Fail 0211812005 DEM Plumbing Rough -ins Fait M95r2005 DEep Framing Fafi t_ City of Blair Building Permit Detail 0212512005 DEM Electrical Rough -ins Fail 0212512005 DEM Mechanical RoughAns Fail 02125/2005 DEM Plumbing Rough -ins Fail 031012605 DEM Mechanical Rough-ins Pass 03/0112005 DEM Electrical Rough -ins Pass 03/01/2005 DEM PlumbingRough4ris Pass 03101/2005 DEM Plumbing Pressure Test Pass 03/01/2665 DEM Framing Pass 0310412005 DEM Septic - Laterals & Drainfields Pass 03/0412005 DEM Water Service Pass 03706/2005 BRT Stop Box Card Pass MM2005 DEM Electrical Permanent Service Pass 061022005 DEM Final Inspection of Project Fail 06/02/2005 DEM Electrical Final Pass 0610212005 DEM Mechanical Final Pass 061622005 DEM Plumbing Final Pass 061362005 DEM Final Inspection of Project Pass BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska Permit Fee: CD 218 South 16th Street Issuance Fee: I w / ZcX cu Blair, Nebraska 68008 11713 Receipt #: 6 •x(402) 426 -4191 • Fax (402) 426 -4195 Permit Deposit Receipt #: IL. K3 � f'` Issue Date: 1 61 (0) 01-- Type: K)i IAi �t' ousc+ JOB ADDRESS 36 , LEGAL 1.DESCfl. NOGW1C.. 3 C)w1C_ Pckt`M1z-.. t ❑SEE ATTACHED SHEET ER MAIL ADDRESS ZIP WORMELL PHONE `>_{a"'"I"1'"1 2. ul�r� cu - cl CONTRACTOR MAIL ADDRESS ZIP HOME PHONE 3 tn ( o V 4.1 +c1 -A S Yl'1 5 a 2& L n'in -itc , ( [ f �l WORKJCELL PHONE 4. Class of Work: Q NEW Q ADDITION Q REMODEL q OTHER Q FINISHED BASEMENT P1 UNFINISHED BASEMENT 5. Describe work: ( /A • h K } ( jLt 3 Crux ( ara 11exF kc �i d A r Ci K a0w B' oFF ey- Vvund OW cl it i b-od r 1- 2 M 54 .PF 6. Valuation of Work: $ �(X)� Total Sq. Footage (Including Basement and G=ge)3q Z 3 Total Finished Area: (p Z Z Floodway O Yes O No Dev. Pcamit Bev. Ced. 7. Floodplain: Fringe O Yes Cl No BFE 8. Current Zoning: o Q Site Plan Attached Q Complete Plans Attached Approximate Completion Date f " 30 uT 9. State Fire Marshall Required: Q Yes g No Inspections Required and Fees 10. Special Use Permit Required: Q Yes No Utiliti 11. Variance Required: [3 Yes [(Vo Sewer Wate erCce 12. Minimum Setbacks: Front 2 . Side 7 Rear � S is �mrte 13. Sidewalk Required: Q Yes KNo Waiver Approved Shop Box Ca d Buildma NOTICE F ngs D Separate permits are required for electrical, plumbing, heating, ventilating and air (� PRIOR TO TAPING) conditioning, and septicsystems. By mysignaturebelow, I acknowledgethat payment of the building permit application tee does not constitute issuance of this building Fr -.F permit. I further agree that construction covered by this permitappiication shall not be commenced until I have received acopyofthis application form signed bytheBuilding Electrical 7t)c Ln Lt5t3fY1C S �L2[ F Inspector. — I hereby agree to performthe proposedwork in accordance With the specificationsset in F' res forth above and in accordance with the codeslordinances of the City of Blair and the Stateof Nebraska. I understand thatthis permit isvoidif work is not commenced within a nentService 1 By s o is no ornpleted within 2 years of date of issue. Temp service G 0 h nic VM �Yl Yy� y' St S{P Vh S GNATURE OWNERrCO ACTOR DATE I -- Ro Comment: T�i4'fa " �j ° I t64 F' O ply Ll�li x� t 4 c) min C� C�ln MEEtI8C. IRC ,IPC,IMCANDNECCODEREQUIREMENTS drt SLEEPING ROOMS BELOW THE FOURTH R REQUIRED TO N VEAN EGRESS WINp011� WHEN PROPERLY VALID T D (IN THIS SPACE TH RMIT A PDUNDePMG. Blab. NE eev.eN6 WARNING: THIS DRAWING CANNOT BE LEGALLY USED TO INSTALLAFENCE OR ANY OTHER STRUCTURE ON THIS PROPERTY, AND IS NOT INTENDED TO BE A LAND SURVEY AS DEFINED BY STATE STATUTES. �` +h ✓¢�� (I6 d 0 15 30 Scale: 1" = 30' 159.23' N '^ N cY � s S4 �" C� N 4 �.3' 4jO V W N, o Wo v CIO 0 w a- I 1 CO co 11 8.51 , SQUARE FOOTAGE ZONING R•L LOT: 23,205 S.F. FRONT: 25 FT. HOUSE: 2,391 S.F. REAR: 25 FT. CONCRETE: 979 S.F. SIDE: 9 FT. DECK: 390 S.F. Q E &A CONSULTING GROUP RS PLOT PLAN ENGINEERS •PLANNERS •SURVEYORS M, Qsudv dh x m w", IhOK 424.w% LOT 4, BLOCK 3, Drawn by: DSH CIhkdby: 11- 2z -o•f Chkaby: OAK PARK FIRST ADDITION Job ' NO.:2004220.01 Date: 11122104 WASHINGTON COUNTY, NEBRASKA K :1Projects12004t226ipg1lSn7 bt PlanslLOT 4, SLK, 3, OAK PARK 1S7 AMWO.dwg, 8,5x14,111221203410:38:35 AM, Cough pppl m r 1 I.w. Y U J � z✓ ,l 55 PI" - -7 A19 8; 49. AGREEMENT eur�srrrt rer_, =�tE This Agreement made this day of�cs� 2065 by and betweenhe City of Blair, Nebraska, hereinafter referred to as "Blair', and 6tv ( gr oSo- a , hereinafter referred to as "Customer'. WITNESSETH: Whereas, Customer has made a request to Blair and hereby makes application for -rntF- water from within the municipality, said water to be utilized at Customer's personal residence, which is located on the following described real estate, to -wit: Whereas, under the terms and conditions as set forth herein, Blair is willing to sell Customer city water. NOW, THEREFORE, BE IT AGREED by and between the parties that for and in consideration of One Dollar and mutual benefits to be derived by both parties hereto, the specific receipt thereof being hereby acknowledged, it is agreed as follows: 1. Customer shall be allowed to purchase water from Blair at a place to be designated by the Director of Public Works of Blair. Prior to installation of the meter and tap, Customer shall submit to the City of Blair plans and specifications acceptable to Blair for such tap and such tap shall be made in accordance with all plans, specifications, and requirements of Blair. Such specifications and requirements shall include but not be limited to the installation of a back flow preventer. Such tap shall be such size as required by Blair and the Customer shall pay for all supplies and materials, except for the water meter. Customer shall notify Blair, prior to commencement of construction and at 57 (25) years from the date hereof. 5. The charges by Blair to Customer for water provided may be adjusted from time to time by the Mayor and City Council of Blair. The Customer shall also be subject to all other rules and regulations of the City of Blair as pertains to its customers of the municipal water system, including but not limited to payment, deposit, and shut off regulations. 6. This agreement shall be binding upon the heirs, personal representatives; successors, and assigns of Customer. This agreement shall also'sp�ctfically run with the land with respect to the real estate described hereinabove and shall be binding upon all grantees, assignees, and subsequent owners of such real estate. The Customer shall be responsible for and shall file a copy of this agreement against said read estate in the office of the County Clerk of Washington County, Nebraska, prior to Blair's providing water service to the premises. CITY OF BLAIR, NEBRASKA BY JaRealph, Mayor ATTEST: `g Bfd n - da Wheeler, City Clerk �GLi SCYi�la 3 ,' I ' STATE OF NEBRASKA COUNTY OF wASHINGTON)SS � ENTER�DINNUMERICAL INDEX AND FILED FOR RECORD stomer PHIS tH-) DAY OF 'n2a&Lh t A.D. 20-2- AT_t 2 - 'CLOC K 1 7 1] 5 ANR GORDEDINBOOK ±F_S R A T PA ) COUNTY CLERK ° 1 �/ Address r)FPLa d - fo0` /- 3116 General Numerical Photostat .I 0 Proofed --- CITY Of UAIQ ti br ° fiise of June 3, 2005 Paul Bruseaard 5801 N. 90 Street Omaha, NE 68134 RE: Final inspection of Building Permit #11713 11302 Rambleddge Drive, Blair, NE 68008 Dear Mr. Brusegaard, On June 2, 2005 Dale Miller did a final inspection at the above location which failed. Enclosed is a copy of the inspection report for your reference. Please note that this project must be completed for a re- inspection on or before Tuesday, July 5, 2005 in order for your $200.00 deposit to be refunded. If you have any questions, feel free to contact either Dale or myself. Thank you in advance for your cooperation in this matter. Sincerely, /�X Brenda Wheeler City Clerk Enc 218 South 16th Street - Blair, Nebraska 68008 • 402 -426 -4191 • Fax 402 - 426 -4195 • E-mail citvofblair @ci.blair.ne.us City of Blair 218 South 16'" Street Blair, NE 68008 Voice (402) 426 -4191 Fax (402) 426 -4195 a F kx ` r ymise 0 To: D. a CA From: Fax: Pages: Phone: Date: Re: CC: Q Urgent ❑ For Review O Please Comment ❑ Please Reply ❑ Please Recycle • Comments% �� - L OL , BUILDING PERMIT REVIEW OWNER: Paul Brusegaard PERMIT NO. 11713 BUILDER: Enviromental Systems CLASS OF WORK: NEW RESIDENTIAL: X ADDITION: NEW COMMERCIAL: GARAGE: REMODEL: TOTAL SQUARE FOOTAGE: MAIN: 1622 sq. ft. SECOND FLOOR: BASEMENT: 1542 sq. ft. SUNROOM: GARAGE: 674 sq. ft. TOTAL FINISHED AREA: 1622 sq. ft. NUMBER OF BEDROOMS: 2 EMERGENCY EGRESS: Egress windows required in all sleeping rooms and basement. DECK: Attached Deck on Rear. PLUMBING FIXTURES: KITCHEN: yes BATH: 2 ROUGH -IN BATH: I (Basement) UTILITY: gas, electric, water & sewer WATER HEATER: gas OUTSIDE FAUCET: 2 HEATING FIXTURES: FURNACE: gas A/C: yes SITE REVIEW: D. Miller CURRENT ZONING: RL 1. LOCATION ON LOT (SETBACKS) A. FRONT YARD REQUIRED: 25' SHOWN: 28'2" B. REAR YARD REQUIRED: 25' SHOWN: 26' C. SIDE YARD REQUIRED: 7' SHOWN: 61' 2. LOT AREA REQUIRED: 6,000 sq. ft. ACTUAL: 25,684 3, LOT COVERAGE ALLOWED: 40% ACTUAL: 8% Plans Reviewed: Dale Miller Date: November 1, 2004 C ITY Of U i� aro /se of BUILDING PERMIT SUPPORTING DOCUMENTS This building permit packet includes various items dealing with particular code requirements and/or building permit requirements. It in no way includes ALL particular code items. Also, it is your responsibility to know the 2003 International Building Code requirements that apply to your project. Please understand this packet is only designed and distributed to aid you in your building permit process. A copy of the International Building Code is available for your use at the Blair Public Library. I have read the above disclosure and accept this building permit documentation on my own behalf assuming full responsibility as the owner /contractor for this project. I ( 2zj �Z� 4 e__ r _ Owner /Occupant Contractor City of Blair Date 218 South 16th Street • Blair, Nebraska 68008 • 402- 426 -4191 • Fax 402 -426 -4195 • E -mail cityofblairphuntel.net ,N„m - i x= CITY Of BtAIQ .. � of BUILDING PERMIT DEPOSIT AGREEMENT A $200.00 refundable deposit is being collected at the time of your building permit application for all permits $10,0000 and above. However, the City reserves the right to not refund this deposit if any of the following conditions occur during the construction period: 1) theft of water service by either the plumber, owner or general contractor, 2) all required inspections have not been obtained, 3) occupancy occurs prior to a final inspection, 4) all permits have not been obtained, and 5) the project is completed without a final inspection being done. If any or all of these situations occur during construction, you may forfeit your deposit. 1, hereby agree to the above conditions, and understand that should any or all of the above situations occur, the building permit deposit SHALL be forfeited or discounted upon the discretion of the City of Blair, Building and Inspections Department. ��� Contractor/C� ner Contractor /Owner City of Blair /©- Date 218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 -426 -4195 • E-mail cityofblalr @huntel.net a-=w - i x= CITY Of BtAIQ .. � of BUILDING PERMIT DEPOSIT AGREEMENT A $200.00 refundable deposit is being collected at the time of your building permit application for all permits $10,0000 and above. However, the City reserves the right to not refund this deposit if any of the following conditions occur during the construction period: 1) theft of water service by either the plumber, owner or general contractor, 2) all required inspections have not been obtained, 3) occupancy occurs prior to a final inspection, 4) all permits have not been obtained, and 5) the project is completed without a final inspection being done. If any or all of these situations occur during construction, you may forfeit your deposit. 1, hereby agree to the above conditions, and understand that should any or all of the above situations occur, the building permit deposit SHALL be forfeited or discounted upon the discretion of the City of Blair, Building and Inspections Department. ��� Contractor/C� ner Contractor /Owner City of Blair /©- Date 218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 -426 -4195 • E-mail cityofblalr @huntel.net a-=w - i x= CITY Of BtAIQ .. � of BUILDING PERMIT DEPOSIT AGREEMENT A $200.00 refundable deposit is being collected at the time of your building permit application for all permits $10,0000 and above. However, the City reserves the right to not refund this deposit if any of the following conditions occur during the construction period: 1) theft of water service by either the plumber, owner or general contractor, 2) all required inspections have not been obtained, 3) occupancy occurs prior to a final inspection, 4) all permits have not been obtained, and 5) the project is completed without a final inspection being done. If any or all of these situations occur during construction, you may forfeit your deposit. 1, hereby agree to the above conditions, and understand that should any or all of the above situations occur, the building permit deposit SHALL be forfeited or discounted upon the discretion of the City of Blair, Building and Inspections Department. ��� Contractor/C� ner Contractor /Owner City of Blair /©- Date 218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 -426 -4195 • E-mail cityofblalr @huntel.net a-=w TG THIELE GEOTECH INC COMPACTION REPORT Project: Brusegaard Residence Job No 04628.0 PM ' D. Thiele Phase' Grading �ocatcn. 11300 Rambleridge Drive, Blair, NE Copies to: Environmental Systems ( Brusegaard), Double D Excavating (Doll) 024293 11!12104 60' W of road, SW comer of fill 20' b'g lbr)wn lean ASTM 104 18 95 3 / +4 99.0 20.2 95 +2 pass 1 1 y 02922 (ayssned) (assanxd) Std 024294 11112/04 40' W of road, NE corner of fill 20' bg wn lean ASTM 104 18 95 -3 / +4 98:9 21.5 95 +4 pass 2 clay D2922 ( (mmd) Std D24295 11/12/04 40' W of road, NE corner of fill 18` bg brown lean ASTM 104 18 95 -31+4 1 101.7 19.7 98 +2 pass 3 clay 02922 (° red (� °�°) Std l 024296 11/12/04 40'W of road, NW corner of fill 19' ^bg brown lean ASTM 104 18 95 -3/+4 99.5 19.7 96 +2 pass 4 clay D2922 (tl (" Std V o l D24297 11113/04 35'W of road, NE comer of lot 16' bg brown lean ASTM 104 18 95 -3/+4 99.0 15.5 95 -3 pass 5 clay D2922 Std D24298 11113/04 60' W of road, SE comer of lot 16' bo brown lean ASTM 104 18 95 -3/+4 102.3 18.1 98 +0 pass 6 clay D2922 ( —"'Ll( (— Std i i ti i Test numbers followed by a letter indk2le a retest - 13476 Chandler Road, Omaha, Nebraska 68138 402656-2171 (Fax 400596-7831) CITY Of UAIQ 9 A`4 1Se of November 11, 2004 Paul Brusegaard Environmental Systems 5801 North 90` Street Omaha, NE 68134 Dear Mr. Brusegaard: Enclosed is a copy of the Variance Application Packet you requested. Once you have completed the application and fulfilled the requirements, I will get a meeting scheduled and get the proper meeting notices sent out. To satisfy notice requirements, the meeting will be scheduled on a date that is approximately three to four weeks from the time the completed application is received. In the packet is the information and criteria the Board of Adjustment will evaluate in considering your application. Since our discussion, I have driven out to the site and taken some photographs to include in the file. Feel free to provide your own pictures of the site as part of your application. At this time I have placed the permit for the new house, 1111713, on hold until the setback issue is finalized, either through a revised site plan or a variance granted by the Board of Adjustment. If you have any questions or would like to discuss the issue firtber, pie, c.o:�t=rct me directly at Blair City Hall at (402) 426 -6691. Thank you. Sincerely Scott W. Bovick Assistant City Administrator 218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 - Fax 402 -426 -4195 • E -mall cityofblalr@cl.blalcne.us ^ a� 7 4 r� -. �PY vP d jt # sue ;s, f d` '+ 4L i err ` x P " R l- x y �x r , ±, aft :_,�'. . ;`• ` /1..4• >� /�.3a -o�/ o2 /� .c� - �t 1 0�,� 6PCP boo m AL TESTING SERVICE STATE CERTIFICATE # P1410 13623 CR 26 PHONE # (402)426 -4851 BLAIR, NE. 68008 FAX # (402)533 -2046 NAME: Paul Brusegaard SOIL TYPE: \ 10' T ADDRESS: 5801 N. 90th St. SILTY CLAY 9'6" E Omaha,Ne. 68134 SILTY LOAM 9' N TEST LOCATION: Oak Park Bik 3 Lot 4 SILTY CLAY LOAM DATE OF TEST: 11/26/04 TO 11127104 - CLAY LOAM F SUM OF PERCOLATION RATES: 42.54 SANDY LOAM 7'6" O AVERAGE RATE: 14.18 SANDY CLAY 7' O MINUTES PER INCH:. 17.14 PRECIPITATION: NONE 6'6" T SN: 112704 -1 10' TEST BORING NONE 6' 5'9" T FIELD DATA SHEET 5'6" E HOLE 1 HOLE 2 HOLE 3 5'3" S TIME FILLI READING LOSS FILLI READING Lb'S3 FILLI READING LOSS' 6' T 7:45 6" 6" 6" 4 ' 9 " 8:15 6" 3 3 - = 6 2 ,d ' 6" 3 V6" B 8:45 6" 3.5 2.$ =: 6" 2.25 3;15= 6" 4 :2 `; 4'3" D 9:15 6" 315 2.25 6" 3 3' 6" 4 -. 4' R 9:45 6" 4 77 3 :3� -? 6" 415 125; 3'9" I 10:15 6" 4 2' 6" 3.25 ,7 6" 4.75 .125` 3'6" N 10:45 6" 4 2 .Y' 6" 3.5 :5`. 6" 5 ` 1 '- 3'3" G 11:15 6" 4 ';'� °`= 6" 3.5 `_2:5;( 6" 4.75 .1:25) 3' 11:45 ' 4.25 1•,75;_ ,,, 3.5 2.5: 5 '1 .`. 2'9" W TOTAL LOSS -17.51 1% 75 38 2'6" A /7ItJo2t?O r5q / =3 1�7gv. 2'3' T PERCOLATION TEST DATA FILE 2' E PERCOLATION READINGS RESULTS 1'9" R START END Elapsed Water Level Percolation 1 Time Water Level Time Time(Min.) (Drop In.) Rates(Min. per In.) 1'3" L 7:45 A.M. 6" 11:45 A.M. 240 17.5 13.71 1' E 7:45 A.M. 6" 11:45 A.M. 240 24 10.00 V 7:45 A.M. 6" 11:45 A.M. 240 12.75 18.82 E WA TE DISP SAL SI ING P ONL SQUARE FEET OF DRAIN FIELD TRENCH REQUIRED FOR A SINGLE FAMILY DWELLING Perc. Rate 1 1 2 1 3 1 4 1 5 1 6 1 8 9 In Minutes Bedroom Bedroom Bedroom Bedroom Bedroom Bedroom Bedroom Bedroom Bedroom Per Inch 200gpd 300gpd 400 gpd 500gpd 600gpd 700gpd I 800gpd 9009pd 1000gpd <5 Systems must be designed with a 12 inch loamy sand liner that would have a percolation rate of 15 to 20 minutes per inch and shall be designed at the 11 -20 minute per inch level 5 -10 165 330 495 660 825 990 1155 1320 1485 210 420 630 840 1050 1260 1470 1680 1890 21-30 250 500 750 1000 1250 1500 1750 2000 2250 3140 275 550 825 1100 1375 1650 1925 2200 2475 41-50 330 660 990 1320 1650 1980 2310 2640 2970 6"o 350 700 1050 1400 1750 2100 2450 2800 3150 >60 Systems must be designed by a professional engineer. Construction permit needed. ` P0_r -iL �Oii6 �,30PM VIASNiNGTON ' FLANNING402426684S No i21(: P. 1I; Lo P4 r Jul 20. 2005 10:23AM WASHINGTON CO PLANNING4024266843 No 2096-2 1/1y.S t .E-- 9 11 6 i ,5A5 113o Z lola2 1�a�� 11255 PAu t�`�sSe. Tomes �mfso& 06 114fl , qp swc Nwy. 91 gw� Azk 1©loz 04k 14 l�tS�i Mgr IS�r{ �1Z5S +2Rmb�'ridq�