PL-2014-00133.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
191ld1i1 Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
PL- 2014 -00133 15e °t a www.blairnebraska.org
04/10/2014 bpeterse PLUMBING Residential April 10, 2014
LOCATIONOFIMPROVEMENT: 390 Ryan Dr, Blair, NE 68008
ARCHITECT: GENERAL Wiese Plumbing
CONTRACTOR:
OWNER: Chad M And Sheila M Lippincott 1515 W Military
390 Ryan Dr Fremont, NE 68025
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Elect /Mech /Plumbing Primary Residence
PROJECT NAME PERMIT EXPIRES 04109/2016
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390RyanDr- 140410 - Plumbing ESTIMATED COMPLETION DATE 4/10/2014
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DESCRIPTION OF WORK
Brand new Sewer service.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheckSUBMITTED: 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
Build g fficial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
ap icat' n.
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Date
Signa a of Applicant