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CITYOF BLAIR
y. 218 S. 16TH STREET
r BLAIR, NEBRASKA 68008
@C It App (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS -2014 - 01775 ° fiise of a www.biairnebraska.org
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07130/2014 MISC Residential July 30, 2014
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LOCATIONOFIMPROVEMENT: 950 N 16th St, Blair, NE 68008
ARCHITECT:
® GENERAL C & S Roofing Inc.
OWNER: Michael J And Lori Aman CONTRACTOR:
2211 Peoples Rd Ste B
A� 950 N 16th St BELLEVUE, NE 68123
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/29/2016 i
950N16thSt- 140730 -2014 Storm Damage ESTIMATED COMPLETION DATE 7/3012016
DESCRIPTION OF WORK
Roof, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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 codesfordinances 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 onstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Signature of Applicant Date
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