rn-2011-00067_0002.tif s
CITY B AIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
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Budding Permit Application ( 402 ) 426 -4191- Phone
(402) 426 -4195 - FAX
RN- 2011 -00067 1 A Se °t q ° www.blairnebraska.org
03/16/2011 RES -NEW Residential March 16, 2011
LOCATIONOFIMPROVEMENT: 109xx Bridgeview Dr, Blair, NE 68008
ARCHITECT:
GENERAL SELF
OWNER: John W And Courtney L Archer CONTRACTOR:
1901 Butler Ave Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Primary Residence
PROJECT NAME PERMIT EXPIRES 03/15/2013
99999 Bridgeview Dr- 110316 -New ESTIMATED COMPLETION DATE
2011 -11 -30
Residential
DESCRIPTION OF WORK
2 bedroom 2 bathroom ranch with ?? finished basement, 2 car garage, with front and rear covered decks.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheckSUBMITTED: Received
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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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.
Signature of Applicant Date