MS-2014-01696_0001.tif i
CITYOFBLAIR
218 S. 16TH STREET
,1I ii BLAIR, NEBRASKA 68008
lilllslll Permit p�JlICatI ® (402) 426-4191 - Phone
(402) 426 -4195 - FAX
MS -2014 -01696 ,se o , ago www.blairnebraska.org
07/28/2014
intern MISC Residential July 29, 2014
LOCATION OF IMPROVEMENT: 1160 Highland Dr, Blair, NE 68008
ARCHITECT: GENERAL Huber Builders, LLC
OWNER: Jeremy J And Molli A Kies CONTRACTOR:
2010 Fieldcrest Dr
= 29 10589 Co Rd Blair, NE 68008
BLAIR, NE 68008 -6399
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f k� vA ' 'T I k e
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 07/27/2016
1160HighlandDr- 140728 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
i
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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
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