MS-2011-00432_0001.tif I
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402)426- 4191 -Phone
(402) 426 - 4195- FAX
MS- 2011 -00432 /se 01 qJ� www.blairnebraska.org MIM
Milli
10/04/2011 brwheele MISC Residential October 4, 2011
LOCATIONOFIMPROVEMENT: 2948 Westridge Dr, Blair, NE 68008
ARCHITECT:
GENERAL. BC Construction
"
CONTRACTOR:
� OWNER: Steven P And Vicki L Shanahan 5041 Co Rd 40 �
2948 Westridge Dr Fort Calhoun, NE 68023
BLAIR, NE 68008 -0000
IM:
NATURE OF WORK PROPOSED USE
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Patio /Driveway Primary Structure
PROJECT NAME PERMIT EXPIRES 10/03/2013
2948WestridgeDr- 111004 - Driveway ESTIMATED COMPLETION DATE
2011 -10 -07
DESCRIPTION OF WORK
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Replace existing driveway. Going back in same footprint. No expansion.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
WIN
MEMB NO
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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.
Signature of Applicant Date
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