MS-2014-00294.tif i
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CITYOFBLAIR
218 S.16THSTREET
BLAiR, NEBRASKA 68008
LIldill I� pp�l�attc�� (402)426.4191 -Phone
MS-2014-00994 pro o\liA! (402) 426-4196 - FAX
M1$ of a www.bialrnebraska.org
INNINNIM
06/1012414 M1SC Residential June 10, 2014
LOCATIONOI:IMPROWMENT: 3304 Adams St, Blair, NE 68008
ARCHITECT:
GENERAL The hoofing Moose
s OWNER: Dale A Hagedorn CONTRACTOR: 20164 Husker D
3304 Adams St GRETNA, NE 68028
BLAIR, NE 68008 -0000
10 M,
NA TURE WORK gp ryy'y �+
NATURE OF YXORK PRt POSED USE
Storm Repair Primary residential and detached garage
PROJECT NAME PERMIT EXPIRES 0610912016
3304AdamsSt- 140610 -Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
House: roof, siding, gutters, windows. Garage: roof, siding, gutters, windows. Deck repair & stain.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor f
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. j
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
application.
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CI TY OF BLAI , NEBRASKA
Phone 402 - 426 -4191
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ADDRESS
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CITY, STATE ZIP CODE
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THANK YOU KEEP THIS,COPY FOR YOUR RECORDS.
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RECEIVED BY
Pounds Printing, Blair, NE 68008