MS-2014-00204.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
uildin Permit Application
(402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS - 2014 -00204 n7 of qo www.blairnebraska.org
00 71
05/01/2014 MISC 77 Residential May 1, 2014
i
r� LOcATIONOFIMPROVEMENT: 2003 Northridge Cir, Blair, NE 68008
ARCHITECT:
GENERAL Acreage Fences
OWNER. Terry L And Kim M Dutton CONTRACTOR 8635 Military Rd
2003 Northridge Cir Omaha, NE 68134
BLAIR, NE 68008 -4204
a
NATURE OF WORK PROPOSED USE
Fence Primary Residence
I
PROJECT NAME PERMIT EXPIRES 04/30/2016
2003NorthridgeCir- 140501 -Fence ESTIMATED COMPLETION DATE 6/15/2014
i
DESCRIPTION OF WORK
81' of 4' pvc fence with 2 gates. 50 %0 open.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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
ap 'c ion. !
c �GCez��
Signature of Applicant Date
OF B U%jR, NEBRASKA
CITY Phone 402 - 426-4191.
FIECEIVED OF: j
ADDRESS.
C1TY, STATE, Z!p CODE �p
{
�Y
I
!
�I
' II
f
I
I
i`
I
i
r
I
i
it KE EP THIS COPY FOR YOUR RECOA
I
THANKYOU
NO RECENED BY
i
!! Blair, NE 6800
Pounds Printing,
i
i
a
o
promise
o'
BUILDING PERMIT DEPOSIT AGREEMENT
I
A $500.00 refundable deposit is being collected for any new commercial, new
residential, and any 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.
/ 5
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 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.
� � I
Contractor /Owner (-Contractorlowner
I
i
City of Blair
I
Date
I
I
I
I
MAY -01 -2014 10 :14 ACREAGE FENCE INC 5715228 P.02/02
3.88 I
f ! k2 t
ddML
gu
Acr
too eaq, 17 In c
i
I
� � I
Tom 'ces
is TC ry 1.t�ra -,c. ► �r�
LLSJ
A03 )9
N air, W e� oc - �
qod - C�1
,?_o-- 14 an Aybor
TOTAL P.02
i
MAY -81 -2814 18 :13 RCREAGE FENCE INC 5715228 P.81f82
rim VC1 E
i
i
F SW' 1 15 Military Rd. w Omaha, NE 681 4
Ph na: (402) 5 71 - 0511 i Fax: l (402 5 71 - 5225
ww .AcreageFencea.com
r NCE, DECK & A 14 1
F
To: Brandy From: D pielle
Fax. 402-426-41 Pages: 2 i cluding cover page
Phones: Tame:51t �4
Re: Blair Fence Pe i# for Terry Dutton
i
I
Please Reply Please Review
+•
Comments
i
I
i
I
i
I
i