PL-2010-00060_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
-� -- B uilding Permit Application (402)426- 4191 -Phone
PL -2010 -00060 ° Mise of qJO\``,. ( www ) www.blairnebraska.org 426-4195 - FAX
0811912010 PLUMBING Residential August 19,
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LOCATIONOFIMPROVEMENT: 1353 Skyline Dr, Blair, NE 68008
ARCHITECT: GENERAL
OWNER: Billy D And Rhonda S Matthews
CONTRACTOR: Henton Trenching, Inc.
13092 U. S. Hwy. 30
3150 Adams St Blair, NE 68008
BLAIR, NE 68008 -1080
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NATURE OF WORK PROPOSED USE
New Construction Primary Residence
PROJECT NAME
PERMIT EXPIRES 0211512011
13434 ESTIMATED COMPLETION DATE 2010 -08 -19
DESCRIPTION OF WORK
Imported Permit
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
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Contractor REScheck/COMcheckSUBMITTED: NA
DEPOSIT HELD: BUILDING PLANS SUBMITTED: NA
N/A
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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 t the cod s /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact I or Piho t e i e n ion of the undersigned or any alteration or change from this application without approval of the
BuilffiII o tit e fficient ground for the revocation of any permit issued which was based on the approval of this
app
Sig �a re of Applicant Date
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