MS-2014-00282.tif i
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CITYOF BLA1R
218 S, 16TH STREET
BLAIR, NEBRASKA 68008
I m B uild ing P erm it App lica tion (402) 426 -4199 -Phone
(402) 426 -4196 - FAX
M5 -2014 -00282 ° `�m� SQ or www.blairnebraska.org
06/09/2014
MISC Residential June 10, 2014 i
LOCAMONOFiMPROVEMENT: 1114 Stone Creek Dr, Blair, NE 68008
n ARCHITECT: GENMAL The Roofing Moose
5 OMER; Steve E And Lisa M Nielson CONTRACTOR: 20164 Husker Dr
1114 Stone Creek Dr GRETNA, NE 68028
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Roofing/Soffit/Eaves/Gutters Primary residential
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PROJECT NAME PERMIT EXPIRES 0610812016 1
11145tone CreekDr- 140609 -2014 Storm ESTIMATED COMPLETION DATE 1213112014
Repair
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DESCRIPTION OF WORM
Reroof, siding, windows following hail storm
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck1COMcheckSUBMITTED 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 codeslordinances 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
application.
Signature of Applicant a
CITY OF BLAIR, NEBRASKA
Phone 402 - 426 -4191
RECEIVED OF;
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CITY, STATE, ZIP CODE
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THANK YOU KEEP THIS;COPY FOR YOUR RECORDS.
NO ' �4rrr� J
RECEIVED BY
Pounds Printing, Blair, NE 68008
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