MS-2014-01099.tif i
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CITYOF BLAIR
218 S.16TH STREET
BLAIR, NEBRASKA 68008
1 (402) 426 - 419'1 - Phone
(402) 426 -4155 -FAX
S-2014 -0 1099 � of
.blairnebraska.org
07/1012014 MISC
Residential July 10, 2014 I
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LOCAWN 1843 Sunrise Dr, Blair, NE 68008
T ARCHITECT: f
GENERAL That Construction Company
MICTOR:
- OWNER: Jean coN
M Holderness 7200 S 84th S
LAVISTA, NE 68128
' 1843 Sunrise Dr
BLAIR, NE 68008 -0000
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NAT URE UJ F WORK ST RUCTURE
Storm Repair Primary Residence
PERM E XPIRES 07/89/2416
PROJECT NAMEf
1843SunriseDr- 140710 -2014 Storm Damage ES TIMA TED PL TIO DATE 1213112014
DESCRIPTION OF WORK
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Re roof, siding
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMcheck SUBMITTED: 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.
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 uilding Inspector is issued.
I . The un ed owner or ent agrees to perform the proposed work in accordance with the specifications set forth above and
in acc dance ith the co s /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact w' h or wit out the i ention of the undersigned or any alteration or change from this application witho t approval of the
Buildi g official, hall o stitut ient ground for the revocation of any permit issued which was based on t e app ova) f this
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applic ti n._
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Date
Signature o Applicant
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