pb-2011-00088_0002.jpg CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
PB- 2011 -00088 1 0 else 01 Q° www.blairnebraska.org
03/28/2011 POLEBARN Residential March 28, 2011
LOCATIONOFIMPROVEMENT: 9233 Cord 37, Blair, NE 68008
ARCHITECT:
� GENERAL Kathy &Frank Desoto
s OWNER: Frank And Kathy Desoto CONTRACTOR: 9233 Co 37 Rd
37 9233 Co Rd Blair, NE 68008
BLAIR, NE 68008 -0000
CH ARACTERISTICS SELECTED OF •
NATURE OF WORK PROPOSED USE
New Construction Accessory Building
PROJECT NAME PERMIT EXPIRES 03/27/2013
9233Cord37- 110328 -1 ESTIMATED COMPLETION DATE
2011 -06 -01
DESCRIPTION OF WORK
Construction of new pole building 30 x 30
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Homeowner
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
AFFA DAVIT OF
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 Offi ' shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
° ' - a p ication.
05
Signature pplica Date