MS-2013-00369.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Permit (402) 426 4191 -Phone
(402) 426 -4195 - FAX
MS -2013 -00369 / S e °, Q ° www.blairnebraska.org
M1111111111=1 MENEEMEMEMEEM
0812912013 bpeterse MISC Residential August 29, 2013
;;,�•> LOCATION OF IMPROVEMENT: 13339 Hwy 91, Blair, NE 68008
ARCHITECT: GENERAL Jorgensen Contracting, Inc.
OWNER: Victor G And Myrna J Brown CONTRACTOR: 530 Front St
91 13339 State Hwy Blair, NE 68008
BLAIR, NE 68008 -0000
LLJ
x r-
NATURE OF WORK PROPOSED USE
Misc. Permit Accessory Building
PROJECT NAME PERMIT EXPIRES 08129/2015
13339Hwy 91- 130829 -Storm Repair 10/1/2013
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Repair to an Accessory structure due to storm damage.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COM check SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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
Buj ' g Official, shall constitute sufficient ' grouTT r the revocati f any permit issued which was based on the approval of this
4ion. p y�
Date
rtign�16re of Applicant