AC-2010-00014_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
AC- 2010 -00014 Ar0 \158 Of q40\\ www.blairnebraska.org
08/02/2010 ACCESS Residential August 13,
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\. LOCATIONOFIMPROVEMENT: 653 N 10th Ave, Blair, NE 68008
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\ \\ ARCHITECT: GENERAL
OWNER: Chad And Janet Brodersen CONTRACTOR: SEL Self
653 N 10th Ave Blair, NE 68008
BLAIRNE, 68008 -1341
NATURE OF WORK PROPOSED USE
New Construction Storage Shed
PROJECT NAME PERMIT EXPIRES 08/01/2012
653N10thAve- 100802- Storage Shed ESTIMATED COMPLETION DATE
2010 -10 -01 �
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DESCRIPTION OF WORK
36'x24' Storage Shed concrete floor - no vehicle access from street
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner REScheck /COMcheck SUBMITTED: NA
DEPOSIT HELD: BUILDING PLANS SUBMITTED: Received
ME
1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. 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.
5. 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 Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app ica on
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Sighaf6re ofApplicant Date