MS-2014-01959_0001.tif I
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CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Application
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MS- 2014 -01 959 Ise 01 Qv�titi www.blairnebraska.org
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08107/2014 ShellyJ MISC Residential August ?; 2g14
LOCATIONOFIMPROVEMENT: 8680 Thompson Dr, Blair, NE 68008 j
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ARCHITECT; GENERA1. McKinnis Roofing & Sheet Metal
J i OWNER: Donna Hilzendeger CONTRACTOR:
164 S 1st St
8580 Thompson Dr Blair, NE 68000
Blair, NE 68008
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 08/06/2016
8580ThompsonDr•140807- 2014Storm ESTIMATED COMPLETION DATE 12/31/2014
damage
DESCRIPTION OF WORK
Reroof on house and shed
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
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
app cation.
Signature of Ap rrcant bate