MS-2010--00034_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
IS - 2010 -00034 ot www.blairnebraska.org
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1/10/2010 bpeterse MISC Residential August 10,
LOCATIONOFIMPROVEMENT: 821 Meadow Dr, Blair, NE 68008
ARCHITECT:
GENERAL
CONTRACTOR: Complete Industries Inc
OWNER: Vesta J Thompson 9402 Fairview Rd
821 Meadow Dr PAPILLION, NE 68046
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Roofing /Soffit /Eaves /Gutters Primary Residence
PROJECT NAME PERMIT EXPIRES 08/09/2012
821 MeadowDr- 100810 -Roof 2010 -08 -20
ESTIMATED COMPLETION DATE
)ESCRIPTION OF WORK
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Re- roofing, tearing off one layer and replacing with asphalt shingles.
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)EPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMlTTED: NA
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)EPOSIT HELD:
BUILDING PLANS SUBMITTED: NA
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No work will be started before a permit is ISSUED AND POSTED.
:. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is issued.
The undersigned owner or agent agrees 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. Any omission of or misrepresentation of
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Building icial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicalidli.
4 re of Applicant Date
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