MS-2011-00389_0001.tif CITY OF BLAIR
216 S. 16Th STREET
BLAIR, NEBRASKA 66006
Building Permit Application (402)426 - 4191 -Phone
(402) 426 -4195 - FAX
MS -2011 -00389 'oo e "o qa° www.blairnebraska.org
09/15/2011 MISC Residential September 15, 2011
LOCATIONOFIMPROVEMENT: 2239 Meadow Dr, Blair, NE 66008
` ARCHITECT:
GENERAL Frank Gabby Siding & Windows
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OWNER: Leroy I And Rebecca J Reynolds CONTRACTOR: P O B ox 85
2239 Meadow Dr Blair, NE 66006
BLAIR, NE 68006 -1169
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NATURE OF WORK PROPOSED USE
Siding Primary Residence
PROJECT NAME PERMIT EXPIRES 09/14/2013
2239MeadowDr- 110915 - Siding ESTIMATED COMPLETION DATE 2011 -10 -15
DESCRIPTION OF WORK
Siding One Section of the house with vinyl siding.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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
pplicatio
gnatur f Applicant Date