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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
MS - 2011 - 00400 �;se os a www.blairnebraska.org
09/2012011 MISC Residential September 20, 2011
LOCATIONOFIMPROVEMENT: 1008 N 23rd Ave, Blair, NE 68008
ARCHITECT:
a ®a GENERAL SELF
OWNER: Stanley Heyden CONTRACTOR:
� 1008 N 23rd Ave Blair, NE 68008
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Blair, NE 68008
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NATURE OF WORK PROPOSED USE
Patio /Driveway
Primary Residence
PROJECT NAME PERMIT EXPIRES 09119/2013
1008N23rdAve- 110920 - Driveway ESTIMATED COMPLETION DATE 2011 -11 -01
DESCRIPTION OF WORK
Extension onto driveway, will be grinding the curb.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner
REScheck/COMcheckSUBMITTED: 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
Building Official, shall cons tit sufficient ground for the revocation of any permit issued which was based on the approval of this
applic i
ignatur of Applicant ?ate