MS-2011-00300_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008 j
Building Permit Application (402)426 -4191 -Phone
MS- 2011 -00300 (402) 426 -4195 - FAX
° "�js° °t au www.blairnebraska.org
08/09/2011 MISC Residential August 9, 2011
LOCATIONOFIMPROVEMENT: 415 W Baronage Dr, Blair, NE 68008
t ARCHITECT:
r GENERAL SELF
` OWNER: Jason D And Rhonda C Peterson CONTRACTOR:
415 W Baronage Dr
as � 9 Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Fence Primary Residence
PROJECT NAME PERMIT EXPIRES 08/08/2013
415WBaronageDr- 110809 -Fence
ESTIMATED COMPLETION DATE 2011 -09 -30
DESCRIPTION OF WORK
6° privacy fence to enclose backyard.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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
r , Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a plication.
Signatu of Applicant Da e