MS-2012-00390_0001.tif i
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OCT -03 -2012 12 :49 ACREAGE FENCE INC _ 5 P.01f02
218 S. '16TH STREET
BLAIR, NEBRASKA 68008
Building Permit App lication (ao z)a26-.1 191 -Phone
(402) 4284195 - FAX
MS- - 003$0 ° ' °mra 01 Q' ° www- blaimebraska.org
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0917712012 MISC Residenkial October 2, 2092
LOCAMONOFMAPROVEMENT: 653 N 12th St, Blair, NE 60008
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ARCMrrEC . GENERAL Acreage Fences
OWNER Barbara J, Trustee Triplett CONTRACTOR" 8635 Military Rd
653 N 12th St Omaha, NE 68134
BL AIR, NE 68008-0000
NATURE OF WORK PROPOSED USE
Fence Primary Residence
PERMIT EXPIRES 09/17/2014
PROJECT NAME
653N12thSt- 120917 -Fence ESTIMATED COMPLETION DATE 10/7/2012
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DESCRIPTION OF W ORK
6' pvc privacy fence to enclose backyard.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck1COMcheck SUBMITTED. NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 j
in accordance with the codeslordinances of the City of Eclair 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 , shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
i� n.
/�, �Y - Date
ignature of Applicant