AC-2011-00198_0001 (2).tif L
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding P ermit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
AC '°"I of www.blairnebraska.org
06/03/2011 bpeterse ACCESS Residential June 7, 2011
LOCATIONOFIMPROVEMENT: 1125 Stone Creek Dr, Blair, NE 68008
ARCHITECT:
Imo; GENERAL SELF
�r OWNER: Timothy J And Yolanda Hauder CONTRACTOR:
1125 Stone Creek Dr Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Pool House /Garage
PROJECT NAME PERMIT EXPIRES 06/06/2013
1125Stone CreekDr- 110603- Garage /Pool ESTIMATED COMPLETION DATE
House 2011 -08 -01
DESCRIPTION OF WORK
i
New garage, pool house and swimming pool. j
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor -Scott Oakes
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
$500
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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 /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, shat, constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
apptlicatio i
Date
Signature of Applicant
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