BP6969USE OF BUILDING
~ 5. Class of Work: EN/ ^ ADDITION ®ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
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
APPLICATION ACCEPTED BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
Site Plan Attached ® Complete Plans Attached ^
Approximate Completion Date ~ _ ~ ~ P
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
Building
Footings Drywall
(before finish)
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NOTICE Framing Final
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
EleCtriCal
building permit application fee does notconstitute issuance of this building permit. I further
agree that construction covered by this permit application shall not be commenced until I
have receivedacopyofthisapplicationformsignedbytheBuildinglnspectorandstamped Rough-in Permanent Service
~APPROVED~,
Iherebyagreetoperformtheproposedworkinaccordancewiththespecificationssetforth Final Tem ora Service
p ry
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,
Is not completed within 2 years of the date of issuance, or if work is abandoned for six (6J fllleCllaniCal
months or longer, whichever is earliest. Rough--n A`C
SIGNATURE OWNER~CONTRACTOR OR AUTHORIZED AGENT DATE Final
Plumbing
~®_ ~ Ground Work
SIG ATURE OF OWNER (IF NER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By; ~ ~° ,~'
POUNDS PRTG: Blelr, NE / Rev. 08195
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