PL-2011-00061_0001.tif i
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
PL - 2011 - 00061 p ' °n,s °s q� www.blairnebraska.org
03/14/2011 PLUMBING Residential March 14, 2011
LOCATIONOFIMPROVEMENT: 1192 S 13th Ave, Blair, NE 68008
ARCHITECT:
® GENERAL Henton Trenching, Inc.
0 OWNER: Les Johnsen Construction, Inc CONTRACTOR: 13092 U. S. Hwy. 30
902 Meadow Dr Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Misc. Permit
Primary Residence k
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PROJECT NAME PERMIT EXPIRES 03113/2013
11 92S1 3thAve-1 01021 -1 -New Residential
ESTIMATED COMPLETION DATE 2011 -03 -14
DESCRIPTION OF WORK
Water and sewer service connections
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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/ordji ances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or with t the intenti n f th undersigned or any alteration or change from this application without approval of the
Building fficial, s all co ft e ffici nt gr wid for the revocation of any permit issued which was based on the approval of this
is ti n. r
Date
Si e of Applicant