RN-2014-00189.tif CITY OF BLAIR
I
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 -4191 -Phone
(402) 426 -4195 - FAX
RN- 2014 -00189 "Ys o+ Q www.blairnebraska.org
04/25/2014 RES -NEW Residential May 1, 2014
ME LOCATIONOFIMPROVEMENT: 7521 N Terrace Trl, Blair, NE 68008
ARCHITECT:
GENERAL J Nielsen Construction LLC
35 n OWNER: Gary W And Karen K Bates CONTRACTOR: 1730 State St
w 18020 Thayer St BLAIR, NE 68008 -1568
BENNINGTON, NE 68007 -0000
PAN 0 1 1 10
NATURE OF WORK PROPOSED USE
New Construction Primary Residence
PROJECT NAME PERMIT EXPIRES 04/24/2016
7521NTerraceTrl- 140425 -New Residential
ESTIMATED COMPLETION DATE 4/25/2015
DESCRIPTION OF WORK
3 bedroom 2.5 bath Ranch with 2 car garage and unfinished basement.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: Received
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
O
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 s id t ground for the revocation of any permit issued which was bAsed on the approval of this
p licatio
--
Signature of Ap ica Date
OF- MR, NEBRASKA
Phone 402 -426 -4131
RECEIVED OF:
r „4
ADDRESS
CITY, STATE, ZIP CODE
j
i
j
4
j
I
a
3
x
ry `
THANK YOU KEEPTHIS COPY FORYOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
a
I
I
a o
`� promis
o�
—BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 ref ad anble deposit is being collected for any new commercial, new
reside ny additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. permits.
The City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
1) Theft of water service by the plumber, owner or general contractor.
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection.
5) The project is completed without a final inspection being done.
6) Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
i
I hereby agree to the above conditions, and understand that should any or
all of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discretion of the City of Blair, Building and Inspections
Department.
3L ontract , dr/0 wner Contractor /Owner
City of Blair
®
7 Al
Date O
I
I
j
C ITV O
o m /se of
BUILDING PERMIT SUPPORTING DOCUMENTS
This building permit packet includes various items dealing with particular code
requirements and /or building permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility 'to know the 2009 International Building
Code 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 Library.
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.
I
i
I
Owner /Occupant 4contractof i
City of Blair ®ate
[JW4MJVf
218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E-mail cltyofblalr @cl.blalr,ne,us J.oJa.R'
I
l
41�
C Lie, �� f lob /
V
I
w+
g
i
i
i
(
Identif from;
' Parcel ID Number Annotation
i-) Parcel ID Number Annotation
®C
i Location 2,688,616 197 625,869 255 Feet
� Field � �._ value_ :.
BookPage 2013 -4772
CalcArea 5.04151
Dissolve Polygon_
Legal SPRING RIDGE LOT 27 12K PC 27 5.04 AC
` Mail l
Mail2 10020 THAYER ST
Mail3 BENNINGTON, NE
OBJECTID 14755
OBJECTID 1 95673
owner BATES, GAR'S W & KAREN IC
_OwnID 1044
ParcelID 890087511
ParcelIdentity 890087511
ParcelType Single Owner Parcel
RID 890087511
Problems
I PropClass 1000
PropType RES
Shape.area 219608.031238
Shape,len 2316.617667
Situs 'VACANT I
TransLevel 0
2ipcode 68007-0000
i
,Identified 1 feature
i
I
I
Friday, Apr 25, 2014 10:25 AM