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CITYOF BLAIR
218 S. 16TH STREET
` BLAIR, NEBRASKA 68008
9 NOV __ ��11ldIDg Permit Application (402) 426 -4191 -Phone
y �� (402) 426 -4195 -FAX
MS -2014 -01905 a ��n, / j ' -of c -- www.blairnebraska.org j
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08/04/2014 MISC Residential August 4, 2014
LOCATION OF IMPROVEMENT: 13746 Co Rd 28, Blair, NE 68008
� ARCHITECT:
GENERAL Black Bison Contracting
i OWNER: Dewey Keith And Vicki Logan Price CONTRACTOR:
VT
1948 Washington St
28 13746 Co Rd Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 08/0312016
13746Co Rd 28- 140804 -2014 Storm damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Reroof, siding and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RES check/CO Mcheck 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 j
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 !
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this E
application.
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Date
Signature of Applicant
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