BP6706~r~=A ~~ f~~rc
~~~' -.
Application Date:
Permit
~` ,,~ , ; ~ .m~ ~~
Issue Date: ,~ <~ " / ~? Permit Fee: $ ,~~~~~
JOB ADDRESS
~{, 1~ `~
~~ i"~ ~ _. _~ f[ c~ ~~
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2, OWNER ), ~ '°°°~ _ MAILADDRESS
I~.. ~ `~. /1~~i t~~~' ZIP PHONE
.3. CONTRACT.... ~~ ~ ~~5~ s' I (Y l ~~. f a fd: l t~--l d~A~ ADDFIESS
/)Q ~ ~j /'~_`~/~ ~~ P ~ NE G~ " ~J~%~t 1 ~'~~,1~- ~ SE NO.
USE OFBUILDING
4.
5, Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: /
C:~.r~ ~~u~C~~~ ~` i -~
~,~, "~ ~ ~
.~~ . ~- ~ ~
.~t`~) /a/
CSI ~
,C ~~ ~~'~
7. Sq. FOOtage Of StrUCtUre (Including Basement and Garage): ff
/
6 7 ~~ I 4 .~ ~ l~ 4,'
~ ~: / -,p r ~ ~U .i
`~ -
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodway Yes^ No ^ Dev.Permit
10 Floodplain: Fringe Yes^ No ^ BFE
EIev.Cer-.
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 _
APPLIC (~ r ~C~~TED 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 1
have received a copyof this application form signed bythe Building Inspector and 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
Nebraska. I understand that this permit is void if work is not commenced within 180 days
orris of completed within 2 years of date of Issue. °'
r ,
m~
SIGNATUA' OF OWNER)CONTRACTOR OR AUTHORIZ~~AGEN~` DATE
Site Plan Attached ~ Complete Plans Attached
Approximate Completion Date
Inspections Required and Fees
Utilities '
~
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
I~ ~~ ~.a _~..~~~_," u,~r_;~r~~~~,~~1 I
Building
Footings Drywall
(beforefinish) ~ ~~'`Y~~~ -~~" ~-~`~~
~'~
'
Framing Final ~
~
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
,~--
Rough-in Mechanical s
q~C ='/'~). ~~)~p~~
Final .~ ~~ <~~
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS)S Y UR PERMIT
Comment: ~ Approved By: f
Y (~~ ~ r ~_
POUNDS PRTG: Blair, NE A
w- e ~
Rev, t D/91
-~
_) ~ ~ ~ -~"
C3 =°
~•-- +^tib °•~ ~~
-.._t _~~ F ~ f
~~ ._--,s
~ ~ ~ ~ ~ ~ ~
~ Q
~~~ ~ ~ o ~
E-~ F, F
~ ~~ ~ ~ ~
U ~~...~ ~
~°~°_~~
~ ~
„~
~ z ~ _ r°' ~ ~ ~ ~
~ ~ ~ E ~" Q Q
4 ~ ~/ ~ ~ ^
~ ~
~ r,~ ~ Q a ~
~w.~ ~ o c?~ ~ u~ ~ ~
7t ~: , ~_ ~= a a o
~~~ ~ w x
o w ~ ~ w z H ~.
~` v ~ ~' w ow. d w a ~
~ '~ ~
1
~ ~
h
°
~
-fie l~
~ ..
J' I
"
V~
-o- ~~
N ~
_ H
-
-- - ~~
--- ----
~ ~
^~ ~~ a
.-a
~/y
V1 Z ~.
~~ `-~, ~1 e
1,
s
~ ~~F~I
' F
C7
~
~-~
~
C~~
Q
W A
~
E
~
3
~"'
~
~
F
~ Gj
vF~ ~
~
I ~
^ ~
w '~
a W
~' ~
o
~
1
~
~
~ ~
~ ~
~ U
r~
p
O
Z
~
~
W
~
U
a W
~
~ L~
a ..
. ~.,v
~
U
~
~
~
~
te
~
W
~ E-~
O q p
~ ~; w
~
..
. .:' r.-~~
i. „` ~ Z n-
`. W ~ .
~; '
o
w
o ~ ~ ~
~ ~ ~ ~
o
~, z .
~ ~ ~
~ ~ Q
~ ~ ~ ~ ~ ~
w ~ o ~
^ ~ ^ ^
x ~ o w
~ ~ ~ w ~
3 =~ ~ ~ ~ z
^ ^ ~ ^ x ~ 'O
F ~ W U
o ~ ~ ~ rz ~ z_ ~ ° ~
w ~ ~ ~ ~ ~ F
°z
Q
a
Q
__ E
-
~
-
_
~
- _
_
-
-
w
-
- __
_
-
w
~
~ O ~
~
~ ~ ~
^ ~ ~ o
~. z
W
~ a ~ C7 Q
a
s o 0
o 0 o
W
~
rx O
~ ~ ~ U ~
v~ ~ u. ~ ¢~ a.
nn
v~ ~, a
~ ~
x ~{.
/t~+
~ ~ H F3 ~~ W
Q
W O .
. C
7 ~ C7 Z
~
F ~ F ~ ~ ~ ~ CA. O F
-~
~ W
~ W ~ a: U ~ ~ C~7
~ ^ ^ W ^ ^ ~ ^ a ^ ~
G
, Z
~.._
I
O
U
W
o.
O
E-' u.
O
a, F
Q.'