MS-2014-0263.tif i
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09/03/2014 WED 18:42 FAX 0003 /004
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Sep, 3. 2014 5 05P CITY OF FLAIR (402. 426. 4191) No, 4964 P. 3
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218 5,16TH STREET
BLAIR, NE13RASKA68008
e rmi Application t�fl�l 426- 4191 � t�har<e
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MS-2014-02563 arOr�,: - . ,��\,�> {402} 428.4196 -FAX
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00143(2014 SI�e11yJ M 150 Residential Septem 3, 2014
L0CATIONOFIMPRO%f8MENT; 2060 Colfax St, Blair, NE 68008
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ARCHITECT-
GENERAL F(S Contraotlhg -
OWNER: Ryan Walpole CONTRACTOR:
- 324 S 13th St
309 S 8th St Tokamah, NE 68061
TEKAMAH, NE 66061-
N ATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXP IRES 0910212016
2068Co1fnxSt- 140903 -2044 Storm Damage ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Reroof, siding and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RE Scheck=MtheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED; NA
$50
0 ONION
1, No work will be started before a permit is ISSUF AND POSTED.
2. For commercial permits, a sot 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, hoating, vQntilating 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,
a. The undersigned owner or agent agrees to perform the pr oposed 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 olteratlon or cha from this application without approval of th
wHN' Offi 1 1, s 3 ii c nst itute sufficient ground for the revocation of any perni t issued which was based on the approval of this
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Date
S €gnature of Applicant
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