MS-2012-00063_0001.tif i
CITE' OF BLAIR
218 & 16TH STREET
BLAIR, NEBRASKA 08008
� 1 B uilding Permit Application (402)426 -4191 -Pno r, j
? , *, (402) 426 -4190 - FAX
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03/1612012 MI Residential March '15, 2012
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LOCATIONOFIMPROVEMENT: 2411 Meadow ter, Blair, NE 68008
ARCHITECT: GENERAL McKinnis Roofing Sheet Metal
OWNER: Steven C And Melanie D Booton CON 164 S 1st St
2411 Meadow Dr
Blair, l'IE 50008
BLAIR, NE 68008 -0000
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NATURE CAP WORD PROPOSED USE
Mis Permit Primary Residence
PROJECT NAME PERMIT EXPIRES 031/5/2014
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241 `t MeadowDr- 120315- Roofing
ESTIMATED COMPLETION DATE 2012 -03 -16
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DESCRIPTION CP WORK j
Re- shingling home,
DEPOSIT PAID :BY; SITE PLAN SUBMITTED: NA
Contractor
REScheck /CO'McheckSUBMITTED. NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED; NA
$50
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 f=ire 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.
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Signature of Applicant Date
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