MS-2011-00420_0001-1.tif i
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CITY OF BLAIR
r .< 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
BUIIC�111g PeP1111t Ap�JlICat10C1 (402)426 4191 - Phone
9� (402) 426 -4195 -FAX
MS- 2011 -00420
�i � www.blairnebraska.org
09/28/2011 MISC Residential September 28, 2011
t LOCATIONOFIMPROVEMENT: 1125 South St, Blair, NE 68008
ARCHITECT:
(a7 GENERAL Frank Gabby Siding & Windows
OWNER: Whitaker, Ellen R Living Trust CONTRACTOR: P O Box 85
1125 South St
Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Siding Primary Residence
PROJECT NAME PERMIT EXPIRES 09127/2013
1125SouthSt- 110928 - Siding
ESTIMATED COMPLETION DATE 2011 -10 -31
DESCRIPTION OF WORK
Siding House.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 j
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
ap licatn°
e ture of Applicant Date
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