AC-2012-00076_0001.tif i
/e CITY OF BLAIR
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218 S. 16TH STREET
1 ali BLAIR, NEBRASKA 68008
Building Permit Application (402 )426 - 4191 -Phone
(402) 426 -4195 - FAX
AC -2012 -00076 01 � www.blairnebraska.org
03/1912012 ACCESS Residential March 28, 2012
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LOCATION OFIMPROVEMENT: 2340 Elm Dr, Blair, NE 68008
ARCHITECT:
GENERAL Tim Anderson Custom Construction Inc.
OWNER: Brian J And Victoria G Atwood CONTRACTOR: 1121 Nebraska St
� 2340 Elm St Blair, NE 68008
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' ' BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Accessory Building
PROJECT NAME PERMIT EXPIRES 03/19/2014
2340EImDr- 120319 -New Garage
ESTIMATED COMPLETION DATE 2012 -06 -01
DESCRIPTION OF WORK
New single car garage and fencing in back yard with a 4' chain link fence. Fence will sit on back property line and a
foot inside property line on east and west sides
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.
Signature of Applicant Date