PB-2012-00440_0001.tif CITY OF BLAIR
' 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application
(402)426- 4191 -Phone
(402) 426 -4195 - FAX
PR 2012 00440 fise www.blairnebraska.org
10105/2012 POLEBARN Residential October 11, 2012
LOCATIONOF IMPROVEMENT. , Blair, NE 68008
ARCHITECT: GENERAL Astro Buildings, Inc.
OWNER: Michael R And Joyce E Co- Trustees Johnsc n CONTRACTOR: 1109 S 19th Suite A
I: 10196 Co Rd P35
Omaha, NE 68108 �
I BLAIR, NE 68008 -9803
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NATURE OF WORK PROPOSED USE
New Construction Agriculture
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PROJECT NAME PERMIT EXPIRES 10/05/2014
Tax Lot 25 in section 8 township N Range
11 East - 121005 -1 ESTIMATED COMPLETION DATE 12/5/2012
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DESCRIPTION OF WORK
Pole Barn
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
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REScheck /COMcheck SUBMITTED: Received
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
application.
Sign6ture°df Applicant Date `
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