DM-2012-00296_0001.tif i
CITY OF BLAIR
C 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
�j a 402 426.4191 -Phone
B uil d i ng Pe rm i t r t III tion (402)426»4195 »FADS
®Mtl�012pOn296 °m, �e www.blairnabraska.org
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87/26/2012 bEMOMOVE Residential July 25 , 2012
.� LOCATIONOFIMPROVEMENT: 362 S 11th St, Blair, NB 68008
ARCHITECT: GENERAL SELF
OWNER: Black Bills /Nebraska Gas Utility Co CONTRACTOR:
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PO Box 1400 Blair, NE 68008
RAPID CITY, SD 577091400
VM �. t` ^•
NATURE OF WORK PROPOSED U SE
Foundation
Demolition
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PERMIT EXPIRES 07/2512014
PROJECT NAM
352S11th$t- 120524»Special ESTIMATED COMPLETION DATE 911/2012
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DESCRIPTION OF WORK
Demo of Foundation
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck /COMcheck SUBMITTED: NA
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DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
1. No work will be started before a permit is ISSUED AND POSTED.
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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, hall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applica ' n
Date j
Signature ofApplica t
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