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CITYOF BLAIR
218 S. 16TH STREET t
BLAIR, NEBRASKA 68008
10 -10 � - -- B uild ing Pe (402) 426 -4191 -Phone
a, (402) 426 -4195 - FAX
S -2014 -00425 °�n;s of a` www.blairnebraska.org
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06/19/2014
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MISC Residential June 19, 2014
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LOCATION OF IMPROVEMENT: 1245 Kristin Cir, Blair, NE 68008 I
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ARCHITECT:
GENERAL Blackstone Exteriors
OWNER: William H And Patricia A Nielsen CONTRACTOR: 1200 HWY 92, Suite B
Winterset, IA 50273
r 1245 Kristin Cir
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRE 06/18/2016
1245KristinCir- 140619 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roofing, siding, gutters
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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. j
5. The undersigned owner or ent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with th codes /o inances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or withol the intentio of the undersigned or any alteration or change from this application without approval of the
Building Official, hall c itute ufficient ground for the revocation of any permit issued which was based on the ap roval of this
application.
Signature of Appli Date
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