2537.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426-4191 - Phone
Building Permit Application -4196 - FAX
(402)426
MS-2014-02537 ise ot www.blairnebraska.org
09710212014 ShellyJ MISC Res .. idential September 2, 2014
LOCATION OFIMPROVEMENT: 13183 Prairie Grass Ln, Blair, NE 68008
ARCHITECT:
GENERAL Triton Exterior
OVVNER: Curtis E And An M Thomas CONTRACTOR:
1625 N 203rd St
13183 Prairie Grass Ln ELKHORN, NE 68022
-4605
BLAIR, NE 68008
ME
N IN E '
190,
L On
NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 09101/2016
13183Prairie Grassl-n-140902-2014 Storm ESTIMATED COMPLETION DATE 12/3112014
dama
DESCRIPTION OF WORK
Reroof, g utters and siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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 re for electrical, plumbing, heating, ventilating and air conditioning, and septic s
4. The undersi 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
cop of a permit si b the Building Inspector is issued.
5. The undersi 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. An omission of or misrepresentation of
fact with or without the intention of the undersigned or an alteration or chan from this application without approval of the
Building Official, shall constitute sufficient g round for the revocation of any permit issued which was based on the approval of this
applicati
Date'
Signature of Applicant