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CITYOF BLAIR j
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
® _ Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS- 2014 -00616 pA ° filse of a� www.blairnebraska.org
06/2612014 MISC Residential June 26, 2014
LOCATIONOFIMPROVEMENT: 1508 Oak Dr, Blair, NE 68008
ARCHITECT; GENERAL F/S Contracting
CONTRACTOR:
OVVNER: Christopher M Dutton 324 S 13th St
Tekamah, NE 68061
1508 Oak Dr
f BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06125/2016
15080akDr- 140626 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roofing, siding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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MI
MEMO
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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.
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
Buildi O icial, sh constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app o %` -
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Date
Signature of Applicant