MS-2012-00127_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
- ®m UIlding Permit Application (402)426- 4191 - Phone
vi z (402) 426 -4195 - FAX
MS - 2012 - 00127 A'O M/Se of a ° www.blairnebraska.org
04113/2012 MISC Residential April 13, 2012
LOCATIONOFIMPROVEMENT: 933 N 28th St, Blair, NE 68008
ARCHITECT:
� - GENERAL SELF
1 OWNER: John M Maschman CONTRACTOR:
933 N 28th St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Primary residence
PROJECT NAME
PERMIT EXPIRES 04/1312014
933N28thSt- 120413 -Fence ESTIMATED COMPLETION DATE 2012 -05 -31
DESCRIPTION OF WORK
6' privacy fence around back yard
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 wita r without the intention of the undersigned or any alteration or change from this application without approval of the
- Buildifi round for the revocation of any permit issued which was based on the approval of this
g ic=sInstitute sufficient 9
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Date
Se of Applicant