MS-2011-00325.tif I
CITY OF BLAIR
218 S. 16TH STREET
' BLAIR, NEBRASKA 68008
. w Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
ArO jh�se ot ° www.blairnebraska.org
08/1812011 MISC Residential August 18, 2011
LOCATIONOFIMPROVEMENT: 8953 John Deere Ln Blair NE 68008
� ARCHITECT:
w GENERAL David P And Nancy E Nielsen
OWNER: David P And Nancy E Nielsen CONTRACTOR: 8953 John Deere Ln
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8953 John Deere Ln BLAIR, NE 68008 -0000
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Grain Bin
PROJECT NAME PERMIT EXPIRES 08/17/2013
8953John DeereLn-1 10818-1 -Grain Bin ESTIMATED COMPLETION DATE 2011 -11 -01
DESCRIPTION OF WORK
33' diameter bin - 34'9" high on agricultural lot
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
ilding Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
i 0plication � .
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Signature of Applicant Date
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CITY OF ' 9 NEBRASKA
Phone 402 - 426 -4191 r
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RECEIVED OF:
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ADDRESS
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CITY, STATE, ZIP CODE
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THANK YOU KEEPTHIS COPY FOR YOUR RECORDS.
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RECEIVED BY i
Pounds Printing, Blair, NE 68008
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BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being
collected for any new commercial, new I
' I and any additions, remodels and accessory building valued $10,000 or
residential , permit application.
greater at the time of your building p
A $200.00 refundable deposit is being
collected for any residential remodel,
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all. misc. permits.
The City
reserves the right to not refund this deposit if any of the following
conditions occur during the construction owner or general contractor.
1) Theft of water service by e
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection. 'n done.
5) The project is completed with ect onpnot'obtained. (If Required)
6) Storm Water Management Plan ns p construction, you may forfeit your
If any or all of these situations occur during
deposit. that should any or
I hereby agree to the above conditions, and de os t SHALL be forfeited or
all of the above situations occur, the building permit r mit p
Blair Building and Inspections
discounted upon the discretion of the City O f
Department.
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Contractor /Owner
� Contractor /Owner
City of Blair
Date