BP6777BUILDING PERMITAPPLICATI®N
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 6 ~ ~ 7
(402) 426-4191 Permit
Application Date: I ~ ylO- ~ ~ Issue Date: ~ C' ~" ~ Z~ ~ Permit Fee: $ ~ ~
JOB ADDRESS ~ ~ ~ , ~ ^ , 1 ~ ~~~ j _
I 'I '~ ~ ^1
-
LEGAL
1 ' DESCR. LOT NO. BLK. T
RACY
^ SEE ATTACHED SHEET
2. OWNER ~~ ~ ,n ~ ~ ~ MAILADDRESS ZIP _ ~ ~ _,7P~NE
(
L
'
~
I~
ENS
NO.
IC
E
MAILADDRESS PHONE L
3. CONTRACTOR
5am~
USE OF BUILDING
4.
5. Class of Work: EW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: -~d~ ~ ~ C~ I I )( 15 '~Z ° o ~ (~ ~~
7. Sq. Footage of Structure (Inducing BeSement ena Gerage):
8. Change of Use From: Change of Use To:
g, Valuation of Work: $ ~~ , [~~
10. Floodplain: Floodway Yes^ No ^ Dev. Permit Elev. Cert.
Fringe Yes^ No ^ BFE
11. Current Zoning:
12. State Fire Marshall Required: Yes ^ No[~
13. Special Use Permit Required: Yes ^ No [~
14. Variance Required: Yes^ Nom
15, Minimum Setbacks: Front Side Rey
16. Sidewalk Required: Yes^ No [ Waiver Approved
A~ATION CCEPTED BY PLANS CHECKED BY APPR FOR ISSUANCE BY
' G ~ ~ Q`i~~9S'
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I acknowledge 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 a copy of this application form signed by the Building Inspectorand stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the specifications set forth
above and in accordance with the codes/ordinances of the City of Blair and the State of
Nebr understand that this permit is void if work is not commenced within 180 days,
i t com eted within 2 years of the ~etp of issuanc,~, or if work is abandoned for six (li)
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
i~-~"3-~~Building ,3-~~'.~~~s~Efiv~a~G~~
Footings - ~ ~ "~ ~~ Drywall
(before finish)/
Framing Final V ~ %' I"~~'
Electrical
Rough-in Permanent Service
Final Temporary Service
Mechanical
OF OWNER100NTRACTOR OR AUTHORIZED
Rough-in ABC _
Final
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE ~ Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
~, ~~~
POUNDS PRTG: BIeU, NE ~ Rev. 08/95
~ o o ~ ~ °c z ~ ~ ~ ~ ~ o ~ o z o ~ ~ o o ~ ~,
y ~ ~ ~ z z ~
r m p 7d ~ p ~ ~ .~ S ..
d ~; ~^ ^ o o ~^ ^ d
/ o ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ z ~~~
~ ~ ~ ~
~,
m
^ ^ '''?~
~G C
~
- V
~
y
try y
i
~
to `-.[
i
O
O .
z '~
^ ~ ^ ^ ^
^
~ S
~ ~
~
~ ~
~
y
`b
~
d
z
0
~'
C~.
0
-~ ~ ,;
H
O :h
~ ~ ~,
~~ ~
~s
~~
;,3, x
4N
1~
_ _,
m ~ r z o x ~ o ~ o d o ~ ~ ~ ~,
m y ~ ~ ~ ~, .~ ~'a~, to ~ ~ ~ ~ ~ ~ p ~ ~ `~
~ n ~fn ~ ~ n o o ~ ~ ~ r
~ ~
j ~ ~ n ~ ~ a ~ z ~ p ~ ~ ^
~~ ~ ~ ~ ~ ~ d ~ ~ ~ ~
d x ~ o ~ ~ 0 1~
~ ~ ~ ~
~ ~ 1
~ ~ ~ r _. ~ ~ ~ z ~
'~ z o . f
~ ~ ~ ~ ~ ~ ~
~ ^ ~ ~ ~~- o
~ ~ ~~ ~
z
~ ^ ) ~ ~ a~ ~
o ~~ y
xl
D
~ a
r
o d
0
m e
~°
-~ ,
O
n
r
r
o`
b
b,
o
(~
~,
~' ~'
~' ^
0 0
~,.
d
0
°z
~b
V
~.
r
'V
5
(V^~'
V
z
o_
~.
0
b
n
~z
0
e
^
0
C
G]
x
O
C
z
c~
a
a
z
H
r~
r~-
a
b
~-C
`~ ~ ~ ~ ~ ~ ~ ~
o ~
~ En
~ ~ o
~ ~ ~ '
b
~ a
z
~ ' ~.j
.
~ 3,
x H Z o
~ o ~ ~ ~
a ~
~ z p
~ ,o L~1 ~ ^
~
to
~ p
~
~
~
~? m
d
~ Z
,.
^ ~
~' ^
~
~ ^
d
~ ~
..
~
~ ~
~ ~
-~ ~
z FBI
ti:~
a
a
r ~
~, ~ •-.µ
<=r..
o y ~
~ ~
~ ~ `~
~ o
~ ~ ~
~ .~
_
~~ o z •
' ~ ~~ ~
~' C -
~3
~cn=vov-t
~~oyzNrc~n
~gz=~z°
~ ooo~ I
~~
am~~N~~
~~a6a~~
~m,,cm~rr-~-c
zcn vNO-m
o~~~ro~
~~o~o~~
~~D+ o
cam`nmzc
m~zr~,. ~cZ
~v.Dncmi~~o
zm_m-iao
oo~m° -~
m
~ --~ ~
~_
~XOgy "'
nr~*t~~~ar
czz ~ m
a°~~'~ zv
~g~o ~~
m ~ =i
~Z
m
~n
0
N
m
3
~~~
,~
~mC
`~Z
3C~
~~D
a V) T
a Q°
r
~~z
¢om
n
~~C
N
°~'~
W
~zm
Nn~
W V/
N
~O
.G
G.~
~ss
d~
. '~.,~
~~g ~ ~ W
~ ~
b
~~~~~~.
.: .a~
N„~~
yi
N
fig'
~1 /
~~
~~./yi
1
ii
c
0
v
0
g
z
o
g m
v o
g v
v
c~
c ~
c
~ ~
z
o ~
~ ~
H
m z
~ ~
H
can O
m Z
v
O
Z
0
0
0
0
m
G
z
m ~
~ o
a~
o -
z
v Z
t~
n
H
H
0
~~
r
H
H
N
~ a
~ ~
0 0
C
x ~
0
m
rn g
0
z
O ~'
H Z
N
o "'
m
z~
C7 0
y g
~ c
zo
O ~
H ~
x~
°
N .~
o ~
m
~ Z
~] ~
~H z
~ v
c
. ~
v
~ o
rN
oZ
x ~
~~
v
O
_~
.T1
0
Z
-~
(n
O
Z
H
0
mc~ID~i
~~
o~
m
c~ z
~ a~o
~
~
o~o-c~
-~ = Z c'-
v r'
z°~r~N
~ --i
ooNa-~ z„
o ;
~
°m~oo o
o
z~"-2v~
? ~
r
~o~co 0
c~~~~z
~~gm z
~"
°
c>v~'~
° c
c
vm,aoo~
~om~
°z z
-
-i
-,
~
~
°
~aa
z
~°o~~
!'~inZ~c
o c;
n
~Na