AD-2011-00451_0001 (2).tif i
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CITY OF BLAIR
218 S. 16TH STREET
J BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
p / (402) 426 -4195 - FAX
AD- 2011 -00451 I to a; a 3p ° g
www. blai rnebraska.or
10/12/2011 ADDITION Residential October 17, 2011
> ° LOCATIONOFIMPROVEMENT: 1124 Stillmeadow Cir, Blair, NE 68008
k ; ARCHITECT:
GENERAL McCaig Construction Inc.
1 A-, OWNER: Rodney L And Ann K Thiemann CONTRACTOR: 1070 James Dr
1124 Stillmeadow Cir Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE j
Addition Primary Residence
PROJECT NAME PERMIT EXPIRES 10/11/2013
1124StillmeadowCir- 111012 - Addition
ESTIMATED COMPLETION DATE 2011 -11 -20
DESCRIPTION OF WORK
Family room addition on north side of the house.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS:
BUILDING PLANS SUBMITTED: Received
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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
6ignature ap� lication. _
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of Applicant ate
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