2764.tif i
i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit plication
(402) 426 -4191 -Phone
MS -2014 -02764 . ( 402) 426 -4196 - FAX
,se of a www.blairnebraska.org
i
09/17/2014 ShellyJ MISC =Residential September 17, 2014 j 7
a LOCATION OF IMPROVEMENT: 423 N 16th St, Blair, NE 68008
ARCHITECT:
GENERAL Scott Stangl
x OWNER: Alfred J And Anita A Latwaitis CONTRACTOR:
6436 Northern Lights
1602 Nebraska St FORT CALHOUN, NE 68023
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 09/16/2016
423N16thSt- 140917 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roofing 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 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 acc rdance with the odes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact (th or without t e intention of the undersigned or any alteration or change from this application without approval of the
Buil i`ng Offi , shall constitut sufficient ground for the revocation of any permit issued which was based on the approval of this
ap ti ation.
S gilature of Applicant Date