414.tif Jun 23 141 Midwest Homes, LLC 4025058265 p.1
CITyW SLAIR
218 S-16TH STREET
BLAIR, NEBRASKA 68008
u i di Perms Appli cations ( 402 ) 426 -4191 - P hone
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M - �, o��`' www.blairnebraska.org
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OI611812014 Iti,fIIS+C Residential June 18, 2014
LocKnoNoFimpR vEmEN7 578 S 25th St Blair, NE 680 08
ARCHITECT GFINERAL Mid west Homes, LLC
•:'' - CONTRACTOR "I(16051Di3th St
r: OWNER Larry C And Mary R Onnen
578 S 25th St Weeping Water, NE +68463
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Primary
Storm Repair
PERMIT EMPIRES 0611712016
PROJECT NAME
57$S25thSt 1406'!8 -2014 Storm Dam ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Asphalt rooting, vinyl siding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
Rl_Seheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
-, -
1. No work wi11 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 Stag Fire Marshal's Office far review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic systern.
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 shad 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 codestordinances 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.
oor Date
Signature of Applicant