AC-2011-00128_0001-1.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
AC-2011-00128 a'omi °�a� (402) 426 -4195 - FAX
se of a www.blairnebraska.org
ACCESS Residential April p ril 20, 2011
AR
g LOCATION OF IMPROVEMENT: 2354 Park St, Blair, NE 68008
F v ARCHITECT:
u }M° GENERAL Jorgensen Contracting, Inc.
I ,U. OWNER: Henry And Marilyn Edson CONTRACTOR: 530 Front St
,- " 2354 Park St
I, rr Blair, NE 68008
BLAIR, NE 68008 -0000
Id
NATURE OF WORK PROPOSED USE
New Construction Accessory Building
PROJECT NAME PERMIT EXPIRES 04/14/2013
2354ParkSt- 110415 -New Garage ESTIMATED COMPLETION DATE 2011 -10 -31
DESCRIPTION OF WORK
27 x 24 Garage with paved approach.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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
ding Official, shall constitute sufficient groond for the revocation of any permit issued which was bas on the approval of this
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