MS-2012-00100_0001.tif i
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
uilding Permit Application (402426- 4191 -Phone
(402) ) 426 -4195 -FAX
MS- 2012 -00100 b10 hise Of aJO�` www.blairnebraska.org
04/04/2012 bpeterse MISC Residential April 4, 2012
LOCATIONORMPROVEMENT: 680 N 3rd St, Blair, NE 68008
ARCHITECT:
GENERAL SELF
D OWNER: Kevin R And Lisa P Rasmussen CONTRACTOR:
680 N 3rd St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Fence Primary Residence
PERMIT EXPIRES 04/04/2014
PROJECT NAME
680N3rdSt- 120404 -Fence ESTIMATED COMPLETION DATE 2012 -05 -31
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DESCRIPTION OF WORK
Replacing length of 6' privacy fence along backside of property.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner
REScheck/COMcheckSUBMITTED: 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
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ng Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
ion.
Date
ggn4atur of Applican t