MS-2011-00469_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B C It Ap plica ti on (402)426- 4191 -Phone
(402) 426 -4195 - FAX
MS -2011 -00469 10 ise 01 www.blairnebraska.org
10/21/2011 MISC Residential October 21, 2011
LOCATIONORMPROVEMENT: 1642 Nebraska St, Blair, NE 68008
:. ARCHITECT:
; GENERAL Robinson Construction
OWNER: Naomi Sue Dugan CONTRACTOR: 1210 H St
1642 Nebraska St TEKAMAH, NE 68061
' W BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Siding Primary Structure
PROJECT NAME PERMIT EXPIRES 10120/2013
1642NebraskaSt- 111021-Siding ESTIMATED COMPLETION DATE
2011 -11 -30
DESCRIPTION OF WORK
Residing house with vynal siding and installing alluminum soffit. Replacing front entry door - same size.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COM check SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
Is
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, shale constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appl}c tion\ �f
/ r
Signature of Applicant Date