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2i it 16 H STREET
BLAIR, NEBRASKAM
P1013 W20iS (�z) X80 -61 - F�hana
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L0CATi0 NoFimpRC)VVENr ¢79 S 1 0th St, Blair, NE 65008
ARCHITECT; GENE iAL Benne Bulldem Inc
Randy J And TonyA P FIIpnAr Lauritzen CO 1096 Co Rd P41 OMAHA, NE 68122
433 9332 Mate liwy
BLAIR, NE GOOO5 -0000
NATURE OF WORK PROPOSED USE
Pritttary Ri idente
Misc. Permit
PERM E XPIRES 1013012016
PR OJECT NAME
679B10th9t- 131030-FaundatI0n Repa ESTIMATED COMPLETION DATE 11 013
DE OF WORK
Repairing Found ®lion dues to slonn In August 2013.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REBGhecie/CQ shack SUBMITTED; NA
DEPOSIT STATUS- BUILDING PLANS SUBMITTED: NA
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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 eiecAlical, plumbing, hosting, 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 spec set forth above and
in accordance with the oodestordinances 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 OfNcial, shall cons ' sufficient ground for the revocation of any permit issued which was based on the approval of this
appliaatio
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B UILDING PERMIT SUPPOR DOCUMENT
This building permit packet includes various items dealing with particular Dods
requirements and /or building permit requirements. It in no way include &L particular
}e items, Also, it is your responsibility 'to know the 2D09 International Buildlog
g2ft requirements that apply to your project. Please understand this packet is only
designed and distributed to aid you in your building permit process. A copy of the
International Building Code Is available for your use at the Blair Public t ibrAry.
I have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the owner/contractor for this project.
s' -- - - -
Owner /occupant antra r y .
City of Blair Date
21 8 South 1 6th StrW * Blau, N91)1 plus 68008.402. 426 - 4191 - Fm 402 - 426 -4196 a E-mcm c ,bkdts+a—