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CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008 j
Building Permit Application t4o2 >426 -4191 -Phone
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(402) 426 -4195 -FAX
AD - 2012 - 00530 „ of a� www.blairnebraska.org
11/1412012 ADDITION Industrial November 16, 2012
LOCATIONOFIMPROVEMENT: 250 S Industrial Park Dr, Blair, NE 68008 j
ARCHITECT: GENERAL Daubert Construction
OWNER: Terra Nitrogen Lmtd Partnership CONTRACTOR: 2180 W Military Ave
4 Parkway N Ste 400 FREMONT, NE 68025
DEERFIELD, IL 60015 -2542
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NATURE OF WORK PROPOSED USE
Addition
Office
PROJECT NAME PERMIT EXPIRES 11/14/2014
250SIndustrial ParkDr- 121114 - Addition to ESTIMATED COMPLETION DATE 1211/2013
office building
DESCRIPTION OF WORK
18 x 24 addition to office building
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: Pending
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
$500
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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, --sh stitute suff' round for the revocation of any permit issued which was based on the approval of this
appH a on.
Date
Signature of Applicant