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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008 I
e wilding ormit Application (402) 4 -4191 -Phone r
_ _ (402) 426 -4195 - FAX
MS- 2014 - 00351 "0110 e t ot a� www.blairnebraska.org k
MISC Residential June 13, 2014
06113/2014 I
LOCATION OF IMPROVEMENT: 1964 Nebraska St, Blair, NE 68008
� = ARCHITECT:
GENERAL Ragole Construction
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1 OWNER: Angela Jean And Robert Laurence Lincoln CONTRACTOR 9721 Military Rd
1964 Nebraska St OMAHA, NE 68134
BLAIR, NE 68008 -0000
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NATURE OF WORK Primary USE
Primary Residence
Storm Repair
PERMIT EXPIRES 06/12/2016
PROJECT NAME
1964NebraskaSt- 140613 -2 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, gutters
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. I
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
wilding Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
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Si nature of Appit