MS-2014-01945_0001.tif i
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CITY017 SLAIR
218 8.16TH STREET
BLAIR NEBRASKA 68006
r r r 482) 426 -4191 - PhOne
p I ild'ng Permit Application �
(402) 42 FAX
MS-2014 0194 ° r od www.blairnebraska.org
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0810812.014 ShellyJ MISC
Residential Aug 7, 231a
LOCATIONOFIMPROVEMEN ' 860 N 14th St, Blair, NE 68008
k ARWITECT: GENERAL Husker Siding & Windows, Inc.
D, - OWNER; Karen S And Rick E Murch- Shafer cOWRAOTOR:
1406 Veterans Br
t� 060 N 14th St
Elkhorn, NE 68022
i BLA1R, NE 88008 - 0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 0810612016
.
880N14thSt-140806 -2014 Storm Damage ESTIMATED COMPLETION DATE 121 31/201 4
DESCRIPTION OF WORK
Reroof and siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck[COMeheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$60
1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of platys for this project must be submitted to the Nebraska State F ire Marshals 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 j
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Buildin Official, shall constitute sufficient ground for the revocation of any permit issued which was based on t he approval of this
ap c tion.
— Date
619na u of Applicant
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