PB-2011-00261_0001 (2).tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
J,Ahsfrl .� U 1'0' . t g _ ' B111IC>11t1g Perm Application (402)426- 4191 -Phone
PE- 2011 -00261 (402) 426 -4195 - FAX
°ra' ,; au www.blairnebraska.org
07/06/2011 POLEBARN Residential July 14, 2011
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LOCATIONOF IMPROVEMENT. 9778 Hwy 75, Blair, NE 68008
ARCHITECT: GENERAL Jorgensen Contracting, Inc.
jln OVWi ER: Gary C And Linda Co- Trustees Asmussen CONTRACTOR: 530 Front St
75 9778 Us Hwy Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Pole Barn
PROJECT NAME PERMIT EXPIRES 07/05/2013
9778Hwy 75- 110706 -Pole Barn ESTIMATED COMPLETION DATE 2012 -07 -06
DESCRIPTION OF WORK
24 x 24 x 9 Pole Barn
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. j
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal 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
ding Official, shall constitute sufficient grou p d for the revocation of any permit issued which was based on the approval of this
appl cation.
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