AC-2012-00425_0001.tif i
CITY OF BLAIR
r 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
rOl'2-00425 uilding Permit Application (402)426 -4191 -Phone
(402) 426 -4195 - FAX
AC- ° m ;Se °t a° www.blairnebraska.org
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10/01/2012 ACCESS Residential October 4, 2012
•' LOCATIONOFIMPROVEMENT: 10024 Cord P35, Blair, NE 68008
ARCHITECT: GENERAL SELF
a OWNER: C Allan And Marian O Ward CONTRACTOR:
10024 County Rd P35 Blair, NE 68008
BLAIR, NE 68008 -0000
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rz;:_ �, *� !!r7 � ,�i,r''',rr,.� ,�- "�.y�� �'�:�=a.�',�,. �. z ='� rrs �T: ���,.�� � � �` ,�- �'� �� � ,: � g�,.�� s-"�' K:�*- �r��'- .:,�� ��fi
.,;;..���w �_�'rT.ei , ��'.;.. 3`'`" cr�v— ..,,.�r`�—;. _.�t,. ,.,..�,., ..,. -,..�a .. �� ,,. - NATURE OF WORK SED USE New Construction sory Structure
PROJE CT NAME IT EXPIRES 10/01/2014
10024Cord P35 - 121001 -New Garage ESTIMATED COMPLETION DATE 4/1/2013
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DESCRIPTION OF WORK
One Story Detached Garage /Storage
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Owner
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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
application. f
Date
Signature of Applicant
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