MS-2014-02031.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
71 � � " -..v (402) 426 -4191 -Phone
Building Permit Application
a � . (402) 426 -4195 -FAX
MS -2014 -02031 °ters of www.blairnebraska.org
08111/2014 brwheele MISC Residential August 11, 2014
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LOCATIONOFIMPROVEMENT: 1761 Park St, Blair, NE 68008
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ARCHITECT: GENERAL SELF
�xr OWNER: Lisa Danielle Hiyke) CONTRACTOR:
1761 Park St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Fence Primary
PROJECT NAME PERMIT EXPIRES 08/10/2016
1761 ParkSt-1 40811 -Fence ESTIMATED COMPLETION DATE 10/3112014
DESCRIPTION OF WORK
5' chainlink fence on back of house attached to garage
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 perirgit. 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 owne or , ent agrees to''perform the proposed work in accordance with the specifications set forth above and
in accordance ith th cQ es/ rd i a c of tli`e City of Blair and the State of Nebraska. Any omission of or misrepresentation of I
with ithout e i ten io of he undersigned or any alteration or change from this application without approval of the
Buil i g I, sh cons u ffi ,ent ground `` #or the revocation of any permit issued which was based on the approval o this
appl a* n ;4
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Signature of Applic nt �
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BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. permits.
The City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
1) Theft of water service by the plumber, owner or general contractor.
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection.
5) The project is completed without a final inspection being done.
6) Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
I hereby agree to the above conditions, and understand that should any or
all of the above situation occur, the building permit deposit SHALL be forfeited or
discounted upon the dis retion of the City of Blair, Building and Inspections
Depart nt. Q `
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City of Blair
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CITY Of I)LAIQ
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FENCE PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular zoning
requirements and /or fence permit requirements. It in no way includes ALL particular
zoning items. Also, it is your responsibility to know the City of Blair Zoning Ordinance
Section 1102 requirements that apply to fences, walls and hedges. Please understand
this document is only designed and distributed to aid in your fence permit process. A
copy of the City of Blair Zoning Ordinance is available for your use at the Blair Public
Library or on our website at www.blairnebraska.org
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I have read the-a ve disclosure and accept this building permit documentation on my
own be f ass mi ull responsibilit as the owner /contractor for this project.
wner /Occu a t Contractor
City of Blair Date
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EOUALHOUSINO
OPPORTUNITY
218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 • E -mail cityofblair @ci,blair.ne.us
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