MS-2014-00305.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS- 2014 -00305 ° hise of C\ www.blairnebraska.org
06/1212014 bpeterse MISC Residential June 12, 2014
LOCATION OF IMPROVEMENT: 1477 Butler St, Blair, NE 68008
ARCHITECT:
GENERAL Black Bison Contracting
e OWNER: Kevin C And Angela S Eggena CONTRACTOR: 1948 Washington St
1477 Butler St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 06/11/2016
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1477ButierSt- 140612 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Re- roofing with asphalt, vinyl siding, gutters and windows.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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
application.
Signature of Applicant Date
CITY OF BLAI, NEBRASKA
Phone 402 - 426 -4191
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RECEIVED OR
ADDRESS
CITY, STATE, ZIP CODE
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THANKYOU ' KEEP THIS COPY FOR YOUR RECORDS.
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RECEIVED 9Y
Pounds Printing, Blair, NE 68008
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