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MS-2014-01771_0001.tif CITYOFBLAIR 218 S. 16TH STREET BLAIR, NEBRASKA 68008 (402) 426-4191 - Phone Building Permit Application - FAX (402) 426-4195 MS-2014-01771 0 /S 01 www.blairnebraska.org Residential July 30, 2014 07/30/2014 :F� IS LOCATION OFIMPROVEMENT: 3052 Anderson Dr, Blair, NE 68008 ARCHITECT: GENERAL Bennett Construction OVVNER: Richard D And Sandra Mohler CONTRACTOR: 205 Main St 3052 Anderson Dr Kennard, NE 68039 BLAIR, NE 68008-0000 IN M�1111N RO 11ft". NO om ow- NATURE OF WORK STRUCTURE Storm Repair Primary Residence PROJECT NAME PERMIT EXPIRES 07/29/2016 3052AndersonDr-I 40730-2014 Storm ESTIMATED COMPLETION DATE 1213112014 Damage DESCRIPTION OF WORK Roof DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA Contractor REScheck/COMcheck SUBMITTED: NA DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA NO 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 revie 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 ot 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. Date Signature of Applicant