BP7254BUIL
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Permit Fee: 30
Issuance Fee:
Deposit Receipt #:
DING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 - Fax (402) 426-4195
Application Date: Issue Date:
Permit
7254
JO DDRESS
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�nair
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LEGAL
1. DESCR.
LOT NO.
BLK.
TRACT
❑SEE ATTACHED SHEET
2. OWNER
l
, MAtLArDDRES
Lt le CS
3 C TRACTO
t
AlAIL
t
ZIP
goon
PHONE
a�- Z.
4. Class of Work: INEW
O AD
TION 17 REMODEL
5. Describe Work:
13 Finished Basement
O Unfinished Basement
oVl
1
-e ctj' _OU 0
6. Total Sq. Footage (Including Basement and Garage):
Total Finished Area:
7. Valuation of Work: $
a
-1c , U O
Floodway
8. Floodplain: Fringe
O Yes
O Yes
O No
O No
Dev. Permit
BFE
Elev. Cert.
9. Current Zoning:
10. State Fire Marshall Required: O Yes
11. Special Use Permit Required: O Yes
12. Variance Required: O Yes O No
13. Minimum Setbacks: Front
O No
O No
Side Rear
14. Sidewalk Required: O Yes O No Waiver Approved
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, 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 bythe Building
Inspector.
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
160.4 s o[ is not completed within 2 y9ars of Ote of issue.
OF
Comment:
)1--1?-9
DATE
O Site Plan Attached O Complete Plans Attached
Approximate Completion Date . _ 36 _2
Inspections Required and Fees
Utilities
Sewer_
Septic _
Building
Footings
Framing
Electrical
Rough -in
Final
Temporary Service
Mechanical
Rough -in _
Final
Plumbing _
Ground Work
Rough -in _
Water Service
Remote
Stop Box Card
Drywall
(before finish)
Final I I
Fixtures
Permanent Service
A\C
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved B . -- ,
Rev. 8196
POUNDS PAM. -Blair, NE
A