2430.tif r
t
,- CITYOFBLAIR F
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
E
Building er i liatin (402) 426 -4191 -Phone c
9
(402) 426 -4195 - FAX
MS- 2014 -02430 C1 /Se of aJd�� www.blairnebraska.org
i
08/25/2014 MISC Residential August 25, 2014
LOCATIONOFIMPROVEMENT: 1404 Lincoln St, Blair, NE 68008
i
ARCHITECT:
GENERAL Bennett Construction
�
OWNER: Douglas A Madsen CONTRACTOR:
205 Main St
608 N 16th St Kennard, NE 68034
BLAIR, NE 68008 -1218
r�-
r
.r , r .. -+�- - , fir- ri`"'�/�� ,-°.r z r'^r',a^.,,, s, y ,--� w .�� .,. ,. T' y . ' �..: .- `-'. ,. � •2 y , �... .v s" w � : ,: .. ;"� .,
"^" ,, ,cM.a... r" , � .�r� r'�. -.x:.
....:.>... ✓, ter . �'� � � ". � „ __ %- N � .,.� � .;r'.
""", :,,�,`,. _ �v _:�-„'✓;,..,. -,. �'”" .�`",..; =,. . - - -:,_. .4- .7:.`...r„r:"'�,: , Ms: , . =za�;C .,r ,.y. ,... ,,r. -_ _,SV >„ .-=� cr; �,,r .,...:� -r., >
�.,k s F,.,., .. ..,.`., �,�..,.�; -„ ,
NATURE OF WORK STRUCTURE
Storm Repair
Primary Residence
PROJECT NAME PERMIT EXPIRES 08124/2016
1404LincolnSt- 140825 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
1 layer tearoff/ 30 yr dim
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
WIN
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 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 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
application.
Date
Signature of Applicant