MS-2011-00242_0001.tif CITY OF BLAIR
`r 216 S. 16Th STREET
t r l BLAIR, NEBRASKA 66006
s, 77777 B uilding ermit A pplication (402)426- 4191 -Phone
(402) 426 -4195 - FAX
MS -2011 -00242 `'`
° 'n, � o, a�, www.blairnebraska.org
MM
0612712011 bpeterse MISC Residential June 27, 2011
LOCATIONOFIMPROVEMENT: 1031 Park St, Blair, NE 66006
ARCHITECT:
GENERAL Olson & Stewart Construction Inc,
z .3
OV&NER: Karene Brenton And Raymond R Ryan CONTRACTOR: PO Box 271
` 1031 Park St Blair, NE 66006
BLAIR, NE 66006-0000
NATURE OF WORK PROPOSED USE
Patio /Driveway Primary Residence
PROJECT NAME PERMIT EXPIRES 12/24/2011
1031 ParkSt- 110627 - Driveway
ESTIMATED C OMPLETI ON DATE 2011 -07 -15
DESCRIPTION OF WORK
Tearing out and repouring a section of existing driveway.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$5®
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, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
ap iction. W
Signature of Applicant Date