RN-2011-00274_0001 (2).tif i
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Q y CITY OF BLAIR F
f � 218 S, 16TH STREET
..tT.�iE +rig OP"',�i t" L Permit App lication (402)426 -41-Phone 0$
BLAIR, NEBRASKA
91 -Phone 1
Building � (402)426- 4195 -FAX
RN- 2011 -00274 f:s or �o www.blairnebraska.org
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07/15 RES -NEW Residential July 21, 2011 f
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LOCATIONOFiMPROVEMENT: 1368 Fieldcrest Dr, Blair, NE 68008 {
ARCH ITECT -
ARCH GENERAL Henry J. Sudbeck Builders, Inc,
OWNER: Jem Investments Inc CONTRACTOR 16265 Woodland Or
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7110 Morgan Gir Omaha, NE 68136
OMAHA, NE 68152 -0000
NATURE OF IA14RI� PROPOSEp USE:.
New Cons#rucfon Primary Residence
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PROJECT NAME PERMIT EXPIRES 0711412013
1368Fieldcres #Or- 110715 -New Residential ESTIMATED COMPLETION DATE 2012 -07 -15
DESCRIPTION OF WORK �
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4 bedroom 3 bath ranch style home with 3 car garage.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: Received
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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1. No work will be started before a '' POSTED.
p ermit is ISSUED AND
2. For commercial permits a se t 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.
a. 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 on the approval of this
a piication.
` nature of Applicant Qz e - - --
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