MS-2014-01296_0001.tif i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008 - 4191 - Phone
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- M Building Permit Application (402) 426
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v (402) 426 -4195 -FAX
MS- 2014 -01296 se os a� www.blairnebraska.org
07/16/2014
MISC Residential July 16, 2014
'•'� LOCATIONOFIMPROVEMENT: 1134 Corey Dr, Blair, NE 68008
ARCHITECT:
s GENERAL AGR Group
OWNER: Chauncey A, Md Wilkins CONTRACTOR: 348 N 76 St
- OMAHA, NE 68114
1134 Corey Dr
BLAIR, NE 68008 -0000
MAW
- P
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/15/2016
1134CoreyDr- 140716 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
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DESCRIPTION OF WORK
Roof, gutters, siding, deck, windows, garage doors
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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. j
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-4r without the intention of the undersigned or any alteration or change from this application without approval of the
Build' fficial, shall c stitute sufficient ground for the revocation of any permit issued which was based on the ap oval this
ap i tion.
Date
Signature of Applica
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