MS-2012-00061_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
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Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
MS -2012 -00061 n 01 a� www.blairnebraska.org
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03114/2012 MISC Residential March 14, 2012
LOCATIONOFIMPROVEMENT: 1463 Linden Dr, Blair, NE 68008
0 ARCHITECT:
0 ; GENERAL Acreage Fences
0 OWNER: Jason M And Kelly J Shaffer CONTRACTOR: 8635 Military Rd
1463 Linden Dr Omaha, NE 68134
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Fence Fence
PROJECT NAME PERMIT EXPIRES 03114/2014
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1463LindenDr- 120314 -New 4' fence ESTIMATED COMPLETION DATE 2012 -04 -16
DESCRIPTION OF WORK
New 4' fence in 2nd front yard and back yard
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
Held
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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
applicati
Date
Signature Applicant
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