sd--2011-00143_0001.jpg u. CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
= Building Permit Application (402)426- 4191 -Phone
o \\ �� (402) 426 -4195 - FAX
SD -2011 -00143 10 Ise of www.blairnebraska.org
04/27/2011 SIGNDECK Residential April 27, 2011
LOCATION OF IMPROVEMENT: 863N 11th St, Blair, NE 68008
ARCHITECT: GENERAL SELF
OWNER: Carolyn G Wiese CONTRACTOR:
863 N 11th St Blair, NE 68008
BLAIR, NE 68008 -0000
SELECTED CHARACTERISTICS O F • .
NATURE OF WORK PROPOSED USE
Addition Primary Residence
PROJECT NAME PERMIT EXPIRES 04/26/2013
863 N 11 thSt- 110427 -Deck
ESTIMATED COMPLETION DATE 2011 -05 -16
DESCRIPTION OF WORK
Remove old deck and replace with new, 16' x 12'
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
AFFA
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, S II onstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applic7ion.
/ 7 /
Sign re pplicant Date