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CITYOF BLAIR
a 218 S. 16TH STREET
s BLAIR, NEBRASKA68008
1 Permit Applica (402) 426 -4191 Phone
(402) 426 -4195 - FAX
S -2014 -02688 ar °�rSe,o�.. www.blairnebraska.org
09/11/2014 MISC Residential Sepfiember I �, 204
LOCATIQNOFIMPROVEMENT: 1733 Lincoln St, Blair, NE 68008
�.., AR GENERAL Home Pride Contractors, Inc.
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OWNER: Lane A Rogers
CONTRACTOR:
,a 5202 tr St
Omaha, NE 68117
20 19370 Co Rd
BLAIR NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PERMIT EXPIRES 09/1012016
PROJECT NAME
1733LincolnSt- 140911 -2014 Storm Damage ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMeheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 c
this building permit. it is further understood that construction covered by this permit application shall not be commenced until <
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 an(
in acc . dance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation c
fact ith or without intention of the undersigned or any alteration or change from this application without approval of the
Bull ing Official, s 31 constitute sufficient ground for the revocation of any permit issued which was based on the approval of thi
is ion.
Date
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