PERMIT APPLICATION (3).TIF i
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CITY OF BLAIR
218 S. 16TH STREET j
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 -FAX
SA- 2012 -00523 blO mIse of Q° www.blairnebraska.org
11/12/2012 SIGN -AWN Commercial November 14, 2012
LOCATION OF IMPROVEMENT: 1143 S Hwy 30, Blair, NE 68008
ARCHITECT:
GENERAL Sign Depot
OWNER: Ltd Ag -Land Investments CONTRACTOR: 1143 S. 30 Hwy
�6 953 Westridge Dr Blair, NE 68008
BLAIR, NE 68008 -1056
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NATURE OF WORK
PROPOSED USE
Sign Shelter Insurance sign
PROJECT NAME
PERMIT EXPIRES 11/12/2014
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1143SHwy 30- 121112 - Shelter Insurance Sign ESTIMATED COMPLETION DATE 12/21/2012
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DESCRIPTION OF WORK
Additional Shelter Insurance wall sign, 8.3 ft x 1.75 ft (14.6 SF)
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
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
fa . th or without the intention of the undersigned or any alteration or change from this application without approval of the
uildin Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appii ikon. —ry
Date
Sig atur eofApplica t