BP5917
Application Date:
BUILDING PERMITApPLICAT10~1V
lV U ~
Issue Date:
Site Plan Attached ^ Comple e P arts c ~d ^
Approximate Completion Date ~~-3d~
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
JOB ADDRESS ~
o
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2, OWNE MAIL DDR~SS ZIP PHONE
3 CONTRACT R ~ _ ~ AIL DRESS ~ ~/ON ~ ~ /~ ~SC~CJ
USE OF BUILDING
4.
5. Class of Work: ^ NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: _ ,,~ ~'
], Sq. FOOtage Of StrUCture (Including Basement and Garage):
8, Change of Use From: Change of Use To:
0, Valuation of Work: $
Floodwey Yes^
10. Floodplain:
Fringe Yes^ No ^ Dev.Permit
No ^ BFE
Elev. cert.
11. Current Zoning:
12, State Fire Marshall Required: Yes ^ No^
13. Special Use Permit Required: Yes ^ No ^
14. Variance Required: Yes ^ No ^
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes ^ No ^ Waiver Approved _
BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I achnowledge that payment of the
building permit application fee does not constitute issuance of this building permit. I further
agree that construction covered by this permit application.shall not be commenced until I
have received acopy of this application form signed bythe Building Inspectorand stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the specifications setforth
above and in accordance with the codes~ordinances of the Ciry of Blair and the State of
Nebraska, I understand that this permit is void if work is not commenced within 180 days
or is n mplet~d wit ' ears of date of issue.
SIGNAT OF OWNER/C ACTOR OR AUTHORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER)
DATE
Sewer
C~~~
Permit Fee: $
Water Service
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final
~rj Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Ground Work
Rough-in _
Plumbing
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: ~ppre e - y;
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit_
5917
POUNDS PRTG: Blelr, NE Rev. 10)91
y ~ 1~
fy:
`~ n
~ _ r
~ ."~
y
~~~ ~
m
q , ~t`
~ {~
~ ~~
1 *~
~.
~~
n' ;r3
R~
(i t ~ y~Ii(`,.,
m '"
t 1 ~~,~\
-" t-, n
a: Y.
f
i^i m
-~ r T
tei .,~
C
t }!.
~ i ~~
;'~~.,
i f~
~_~ ~
i
( ~ `~ {
~` f~' ,v
la 1.:]
`~
~~
!>; \
V \
n ~~
r
r•
~~
^~ ~..
~n
~.
1 k.
.~ ~~
(~€ L 1 Iti
`_
.. h
..~
~
~
r ~..~
4
j ~
p r ~
~
'. n
u { a t.~ r r. J ~ rv ~i :. ~
', ~ !C -y ~':rw `s^/
a ~ n y "::1 ~ l 7 i
J ~: ~ ~ n ~ .1
f
x J
, ~ ~~ ~
f ~~ 1 ~ ~ , ...~!
' ;
a '~ h° 41 'Y
` I.
J
~`'
~C~
.I
~ ~
~?
1..1 .
~
,a µ
~
~ ~
~ '
,
~ I
f /
t'
i ~'
'
` t ~. j f
1
Gi c: .~ ~. t .. ~1 I i.. r~
f",
~
s
~:;
f f
~
L.~
.. ~
f; t ~~ _1 ~
,, i ''
~...~ ~; r~ ,,;
r ~~ C` ~ ~
t" rah '.
t.J
1 C7
6 ~ i~
( .., j
_ _ ( f
'('
1
n
r
}' ,
;:
"~ "
1' >',
~~
=c ("i
R ~~'
'J
f
~~`~-a
c
F Y1
.
i~
is
µ
~.
+ ,
i~ 1 ._
~?:
f Z ..
,*: ~ 6
r t=
a
`~
z
~
! "~
rv
r ~
~ ~ ~ n
~
ni ..
-o ~
~
.
j
~, .. r ~ e =
r
w F ~.~
v
~ ~ ~ = ~...1 L~
"
'
f
~ *~
`,'s' pry
,
if
€; ~ r
f
,~ ~ .1 ~
O
t '
I ,
~ ~~
~`'> k 1-'
,
~
f j x . f
~; 1=~
i
1'
..
rv (s ~
~ C
1, :.
.~
f rr ~ ~y
W
~ ~ ~ y, a W .1 ~ ~~
"
%
I
4
`'
}
I_7 ,~ ' ~ (. ~ ~ x ~,
t"
i-7
f 1
i ~s
f :7 -
Ef ,
1 ~
~
= -
1
~
~ ',
:~ F-
i i `'
~j ~
Y I
,- ~ :~ J = ~J r
f
C t
y
j
-
I
=1
;=' -
r`
~ ~:.
<
_
~: ~
p 1
f `' ~
I
t
k ` ~
T.t
~ FN
y
~ r-~
~_
~ ,, ~
t i :~
'
i
f
-
t-'
Y ,..y
_~ •~
i
1
t
I mo.
.
1' ,
`! ( ~ I
.~
.
,
1 ~
~
I 1