PB-2011-00260_0001 (2).tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
l� Building P @PIl11t /4pplICatlOfl (402)426- 4191 -Phone
P , I _����� o �� � (402) 426 -4195 - FAX
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arse of « www.blairnebraska.org
07/06/2011 POLEBARN Residential July 19, 2011
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LOCATIONOFIMPROVEMENT: 13623 Cord 26, Blair, NE 68008
i.: ARCHITECT:
t; GENERAL Jorgensen Contracting, Inc.
°i OWNER: James Henton CONTRACTOR: 530 Front St
r l 13623 Co Rd 26 Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Pole Barn
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PROJECT NAME PERMIT EXPIRES 07/05/2013
13623Cord 26- 110706 -Pole Building ESTIMATED COMPLETION DATE 2012 -07 -06
DESCRIPTION OF WORK
30 x 50 x 12 Pole Building
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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
B 'ng Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
lic tion.
VCIL
Signature o A pli�, nt
Date