DR-2012-00085_0001.tif APR -11 -2012 14:27 AA WINDOWS 'N' DOORS 402 763 1766 P.02
CITY OF BLAIR
218 S. '16TH STREET
I�t BLAIR, NEBRASKA 68008
4g1F „�>� a� 111 0 Z� B P erm it A ppli ca ti o n (402)426.4191 -11l
DR- Q ,� o ® (402) 428.4195 - FAX
220085 - www.611-1—. bra s ka,arg
03!2212012 bpeter$e ❑ECKFAMP Residential April 11, 2012
LOCATIONOF IMPROVEMENT, 10749 Cord 29, Blair, NE 68008
ARCHITECT;
GENERAL AA Windows N Doors
O vkNER: Philip E And Katherine L Dudrick CONTRACTOR: 1304 S Saddle Creek Rd
2910749 Co Rd Omaha, NE 68109
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Deck Primary Residence
PROJECT NAME PERMIT EXPIRES 04111/2014
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10749GoRd29- 120321 -Deck ESTIMATED COMPLETION GATE 2012 -06.31
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DESCR IPTION OF WORK
Wood deck on back of the house.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/CCMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
$50
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1 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
app lication.
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I�nskure of Applicant
Date
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