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218S.16THS
BI.(ildina Pa11 mit Ap plication (dn7) & ?f. tq-j - p15,
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MS -201,4- 0176 a a } �'' ``� vmw,blain;:L -4r 1Ce. ar
07130t �I Is isc identi l ,July W,
�C(A' XF 4 h9 t is 24 Riverview fir, $]sir, HE 6800
C;E" -POJ. VWfey Boys, Inc_
14547 Bande,;;son Cir
220 Ri Dr
Ornall.), NE 1130122
BLA[k NE MOOS -041I0
777777TE
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Bf 1 epair Prirn *rY Residence
PROJECT NAME � PERMIT EXPIRES DTF24)12aia
224ivervieti #rDr 14[�T3o .$tor Darrtag
ESTIMATED C DATE 12,
i
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBM TTED: I
REScheck COMchec1:r SUBMITTED: N
DEPOSIT aTATLIS. BUILDING RLANS SU BMITTto: NA
i'.
1 Nova`ofk will be .549 Red be-fom. a permit is ISSI,IF_ (3.aND PO ;T 0,
2: For commercial permit: ; a ! soj of plans for this project muzit to subn itl�•d to the Nr�araska State. Firo Mamh -lrs Office for repvlcw,
3. SeparaW purmits axe required for eledrital, plrumtti:°izi, he•aiinq, VenliIvtirtg and ir Cmrjitioninsi, &id s tiff tc .
4. `I hie undersigned twimer or ajcomt ur d rMt�rn<i and 1 ,vhf
udqes INS building ppnniit appl t�ti �i � nr�t 9n �titu3F ate, O - ICE! 0
this building poarnit. It is further undc-ff,400d that ooris(ruclibn , ),Iv d by fts ,patrnit applic rtiur, shall not ie comme -ne v4 until
4dpy Of a peril - lit �sigrjed by thw Building Irispector is issued.
The «rttlomigned (Y.am w or agent agrees try pe -rfoog lite prpp,0uncl work in with the speciftw1ions set forth ��: above l
In mrclance Arith ;n, t
the codes,fordncc,�. of the City of Blair mid the Stag of Nobr sk-.3, Any iF, %ion of or misr�,r rlt-- �t
a n of
Fart h4th or withmit Zhu intention of the undersignod or anV lturation or c;Irange from this appli '*0r1 V-ithOLA appraeval of triul
Buildin ff c .irfIirient grj[,rr7ft rar the rev000 cton of any rxornit issued which was on the apprey ar of this
_..1.
51gnatum of Appt mane L
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