MS-2012-00426_0005.tif I
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
426 -4191- Phone
Building Permit Application ( 402 >
9 a� (402) 426 -4195 - FAX
MS- 2012 -00426 Aro "Ilse of Q- www.blairnebraska.org
10/0112012 bpeterse MISC Residential October 1, 2012
A LOCATIONOFIMPROVEMENT: 1040 Joann Dr, Blair, NE 68008
ARCHITECT: GENERAL S & W Fence Inc. j
OWNER: Rachel A And Craig D Hambidge Hagerma i CONTRACTOR: 15803 Pacific St
1040 Joann Dr Omaha, NE 68118
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED
I N
USE
Fence Primary Residence
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PROJECT NAME PERMIT EXPIRES 10/01/2014
1040JoannDr-1 21001 -Fence 10/20/2012
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
4' wooden fence to enclose back yard
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
Held
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1. No work will be started before apermit 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
application.
Date
Sign ture of Applicant