AD-2011-00507_0001.tif i
fi' fi CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 -4191 -Phone
`' ` (402) 426 -4195
AD- 2011 -0 05 07 -FAX
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11/11/2011 ADDITION Residential November 16, 2011 7
LOCATIONOFIMPROVEMENT. 1829 Lincoln St, Blair, NE 68008
ARCHITECT:
GENERAL Leonard W. Larsen
e OWNER. Dale Miller CONTRACTOR: 1450 Adams St
h�tlp 1829 Lincoln St Blair, NE 68008
Blair, NE 68008
NATURE OF WORK PROPOSED USE
Addition Accessory Building
PROJECT NAME PERMIT EXPIRES 11/10/2013
1829LincolnSt- 111111 -Garage Addition
ESTIMATED COMPLETION DATE 2011 -12 -15
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DESCRIPTION OF WORK
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Adding a 2 car attached garage to existing 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
application.
Date
gnature of Applicant