RE-2010-00253_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426-4191 -Phone
RE-2010-00253 (402) 426-4195 - FAX
ise of www.blairnebraska.org
Residential December 10, 20
. 11130/2010 7M7 707D7 E L __7
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LOCATION OF IMPROVEMENT: 1640 Grant St, Blair, NE 68008
ARCHITECT:
GENERAL SELF
O\ANER: Patti Behnk CONTRACTOR:
M
Ph 1640 Grant St Blair, NE 68008
Blair, NE 68008
NATURE OF WORK PROPOSED USE
Remodel Primary Residence
PROJECT NAME PERMIT EXPIRES 11/29/2012
1640GrantSt-1 01 130-Remodel ESTIMATED COMPLETION DATE 2011-07-30
DESCRIPTION OF WORK
Changing size of one window in kitchen, moving section of privacy fence, and replacing driveway
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 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
application.
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Date
Signature of Applicant