MS-2012-00479_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
402 Building Permit Application
426 - 4191 -Phone
(402) 426 -4195 -FAX
MS- 2012 -00479 p1O �,s e o1 ° www.blairnebraska.org
10/22/2012 MISC Residential October 22, 2012
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LOCATIONORMPROVEMENT: 1102N 20th Avec, Blair, NE 68008
ARCHITECT: GENERAL S & W Fence Inc.
®, OWNER: Patrick A And Mary J Grover CONTRACTOR: 15803 Pacific St
a 2803 335th St Omaha, NE 68118
LOGAN, IA 51546 -5088
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NATURE OF WORK PROPOSED USE
Fence Primary- Residence
PROJECT NAME PERMIT EXPIRES 10122/2014
1102N20thAvec- 121022 -Fence ESTIMATED COMPLETION DATE 1212212012
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DESCRIPTION OF WORK
48' Fence total lenght 133'
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: Received
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 ufficient ground for the revocation of any permit issued which was based on the approval of this
applibation.
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Date
Signature of� licant