RN-2011-00164_0001 (2).tif i
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N CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
M !-Mx Building Permit Application (402)426- 4191 -Phone
a ,r ����_ (402)426 -4195 -FAX
RN- 2011 -00164 '�nr os a o° www.blairnebraska.org
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05/13/2011 RES -NEW Residential May 13, 2011
n LOCATIONOFIMPROVEMENT: 9999 Spring Ridge Lp, Blair, NE 68008 C
ARCHITECT:
GENERAL Nielsen Construction Co -Blair
OWNER: Nielsen Homes and Develop ent Inc CONTRACTOR: 1730 State St
1730 State St BLAIR, NE 68008 -1568
BLAIR, NE 68008 -0000 f
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NATURE OF WORK PROPOSED USE
New Construction
Primary Residence
PROJECT NAME PERMIT EXPIRES 05/1212013
9999Spring Ridge Lp- 110513 -1 ESTIMATED COMPLETION DATE
2011 -12 -31
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DESCRIPTION OF WORK
New Residential with 4 bedrooms,5 bathrooms, unfinished basement, 3 car garage
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
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Contractor
REScheck /COMcheckSUBMITTED: Received
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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.
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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
Buildiag Officia shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicatio .
Signaturg 6i pplicant Cam'` Date
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