DR-2012-00313_0001.tif fr CITY OF BLAIR
j 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
T UIlC�Itlg Permit Application
(402)426- 4191 -Phone
F� e (402) 426 -4195 - FAX
DR 2012 - 00313 °'oms� or ��� °� www.blairnebraska.org
IN
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08/0212012 DECKRAMP Residential August 14, 2012
LOCATIONOFIMPROVEMENT: 1116 N 28th St, Blair, NE 68008
ARCHITECT: GENERAL SELF
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OWNER: Seth E And Maureen E Nowak Bray CONTRACTOR:
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1116 N 28th St Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Deck Primary Residence
PROJECT NAME PERMIT EXPIRES 08102/2014
1116N28thSt- 120802 -Deck 9/1/2012
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
12' x 30' deck for the back of the house.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner
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
plica ion.
�ature of Applicant Date
0
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