MS-2011-00468_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uild ing r It Application (402)426- 4191 -Phone
9 g �. (402) 426 -4195 - FAX
MS- 2011 -00460 ° rais e Ot www.blairnebraska.org
10/21/2011 MISC Residential October 21, 2011
'i LOCATION OF IMPROVEMENT: 1002 Deerfield Blvd, Blair, NE 68008
3 ARCHITECT:
GENERAL BDRConstruction
a
OWNER: Congregation Of Jehovah's Witnesses Inc IaiF 13620 Co Rd P18
4 ' , 665 N 11th St Blair, NE 68008
BLAIR, NE 68008 -1331
1A
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NATURE OF WORK PROPOSED USE
Patio /Driveway Church
PROJECT NAME PERMIT EXPIRES 10/20/2013
1002DeerfieldBlvd- 111021- Driveway - -
ESTIMATED C OMPLETI ON DATE 2011 -02 28
DESCRIPTION OF WORK
Replacing and repairing concrete for driveway and walkway.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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.
Date
Signature of Applicant