PL-2013-00389-1.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
PL-2013-00389 {` (402) 426 -4195 - FAX
° ns� os ago www.blairnebraska.org
09/05/2013 bpeterse PLUMBING Residential September 5, 2013
� LOCATIONOFIMPROVEMENT: 9579 Pine Crest Rd, Blair, NE 68008
ARCHITECT:
GENERAL SELF
OWNER: Scott E And Julie A Hayes CONTRACTOR:
9579 Pine Crest Rd Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Sub -Work New Const Accessory Building
PROJECT NAME PERMIT EXPIRES 09/05/2015
9579Pine CrestRd- 130828- Accessory
Building ESTIMATED COMPLETION DATE 9/5/2015
DESCRIPTION OF WORK
Sewer and water line for accessory building.
DEPOSIT PAID BY: SITE PLAN SUBMITTED. NA
NA
REScheck /COMcheck 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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicatio ,
Signature of Applicant Da/to