Miscellaneous Permit
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426-4191 – Phone
(402) 426-4195 – FAX
building@blairnebraska.org
www.blairnebraska.org
MISCELLANEOUS PERMIT
PERMIT NUMBER: MS-2021-00251 EXPIRATION DATE: 10/25/2023
ISSUED: 10/25/2021 PAID AMOUNT: $115.00
PERMIT TYPE: RECEIPT #: 64849
JOB SITE ADDRESS: 13291 MATHIESEN DR PARCEL # 890077735
TYPE OF WORK: MISCELLANEOUS LEGAL DESCRIPTION Sunrise Estates Lot 9
VALUATION: $44,895.00
ZONING DISTRICT: GENERAL AGRICULTURE CONSTRUCTION TYPE MISCELLANEOUS
IN ACCORDANCE WITH THE APPROVED PLANS AND SPECIFICATIONS AND PAYMENT FOR THIS APPLICATION BY:
PRIME CONTRACTOR: OWNER:
MARC JONES CONSTRUCTION DEBORD SCOTT & RACHELLE
22171 MCH RD 13291 MATHIESEN DR
MANDEVILLE LA 70471 BLAIR NE 68008
PERMISSION IS HEREBY GRANTED TO:
Adding solar panel to the west roof line and southern most gr
Fee Description Quantity Price
PERMIT ISSUANCE FEE 1 25.00
MISCELLANEOUS PERMIT FEE 1 40.00
DEPOSIT 1 50.00
TOTAL 115.00
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN SIX (6) MONTHS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF SIX (6) MONTHS AT ANY TIME AFTER WORK IS STARTED, OR IF
WORK IS NOT COMPLETED WITHIN TWO (2) YEARS OF DATE OF ISSUE.
NO PREMISES SHALL BE OCCUPIED UNTIL A CERTIFICATE OF USE AND OCCUPANCY OR A WRITTEN CONDITIONAL OCCUPANCY APPROVAL BY THE
BUILDING OFFICIAL HAS BEEN ISSUED. THIS PERMIT DOES NOT AUTHORIZE ANY ENCROACHMENT ON PUBLIC PROPERTY.
SEPARATE PERMITS ARE REQUIRED FOR BUILDING; ELECTRICAL; PLUMBING; HEATING, VENTILATING AND AIR CONDITIONING; SEPTIC SYSTEMS;
AND SPECIFIC MISCELLANIOUS WORK. ALL WORK SHALL BE PERFORMED IN ACCORDANCE WITH THE SPECIFICATIONS SET FORTH ABOVE AND IN
ACCORDANCE WITH THE CODES & ORDINANCES OF THE CITY OF BLAIR AND THE STATE OF NEBRASKA.
THE ISSUANCE OF THIS PERMIT IS FOR THE WORK SPECIFIED IN THE APPLICATION FILED. THEREFORE ANY UNAUTHORIZED CHANGE OR
ALTERATION FROM THE AFORESAID APPLICATION OR PLANS WILL RENDER THIS PERMIT NULL AND VOID. ALL CORRECTIONS OR ALTERATIONS
NOTED IN ANY ADDENDUMS ISSUED BY THIS DEPARTMENT SHALL BE MADE A PART OF THE APPROVED PLANS AND SHALL BE PERFORMED AND
INCORPORATED INTO THE WORK. THE ISSUANCE OF A BUILDING PERMIT, OR THE ISSUANCE OF AN APPROVED SET OF PLANS DOES NOT
ABSOLVE THE OWNER, OR CONTRACTOR, FROM COMPLYING WITH ALL REQUIRED CODES & ORDINANCES.