20131011122104426_0001.jpg CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
9 .�' (402) 426 -4195 - FAX
PB- 2013 -00471 A '�n,; se of www.blairnebraska.org
10/11/2013 POLEBARN Residential October 11, 2013
LOCATION OF IMPROVEMENT: 947 Skyline Dr, Blair, NE 68008
ARCHITECT:
III
GENERAL SELF
1 OWNER: Brad Alan And Jane Ann Jaworski- Andersen CONTRACTOR:
ft'd8 hie Dr
Blair, NE 68008
BLAIR, NE 68008 -1859
,,,(� OF WORK
5
NATURE OF WORK PROPOSED USE
New Construction secondary structure
PROJECT NAME PERMIT EXPIRES 10/11/2015
947SkylineDr-13101 1 -Pole Barn
ESTIMATED COMPLETION DATE 10/11/2015
DESCRIPTION OF WORK
40 x 80 metal pole barn with fine rock floor, no electrical or plumbing, one garage door, one walk thru
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: 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 wi ut the intention of the undersigned or any alteration or change from this application without approval of the
Building,] c -; ,shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applit ion
Signature of Applicant Date