AC-2011-00316.tif i
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CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
AC- 2011 -00316 /Se o1 www.blairnebraska.org
08/1612011 brwheele ACCESS Residential August 18, 2011
LOCATIONOFIMPROVEMENT: 1011 N 27th St, Blair, NE 68008
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ARCHITECT:
GENERAL SELF
OWNER: Alan W And Elaine Engelke CONTRACTOR:
1011 N 27th St Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
New Construction Accessory Building
PROJECT NAME PERMIT EXPIRES 08/1712013
1011 N27thSt-1 10816-Shed ESTIMATED COMPLETION DATE 2011 -10 -01
DESCRIPTION OF WORK
10 x 14 shed. No electric.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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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
application.
Date
Signature of Applicant
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CITY OF BLA NEBRASKA
Phone 402 - 426 -4191
RECEIVED OR
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ADDRESS U
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100 N - -1
CITY, STATE, ZIP CODE
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THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
NO }
RECEIVED BY `+
Pounds Printing, Blair, NE 68008
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