MS-2012-00342_0001.tif i
CITY OF BLAIR
r5 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit A pplication (402)426- 4191 -Phone
(402) 426 -4195 - FAX
MS - 2012 - 00342 '�mrs 01 www.blairnebraska.org
08/20/2012 bpeterse MISC Residential August 20, 2012
LOCATIONOFIMPROVEMENT: 2243 Park St, Blair, NE 68008
ARCHITECT:
GENERAL SELF
OWNER: Adam J And Ashley N Klahn Hopple CONTRACTOR:
2243 Park St Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK
PROPOSED USE
Fence Primary Residence
PROJECT NAME PERMIT EXPIRES 08120/2014
2243Parkst- 120820 -Fence ESTIMATED COMPLETION DATE 10/3112012
DESCRIPTION OF WORK
6' privace fence to enclose backyard and replace old fence. Will sit on property lines on all three sides.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner
REScheck/COM check SUBMITTED: NA
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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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
lication.
ate
Si ture of Applica t
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