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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
MS- 2 ® 14 - ® 28 ® 3 a �o,� x (402) 426 -4195 -FAX
he of a www.blairnebraska.org
09119/2014 MISC Residential September 19, 2014
LOCATIONOFIMPROVEMENT: 551 N 10th St, Blair, NE 68008
ARCHITECT: GENERAL Hoffman Weber Construction Inc
OWNER: Daniel Lloyd Loseke CONTRACTOR:
3515 48th Ave N
551 N 10th St MINNEAPOLIS, MN 55429
a
BLAIR, NE 68008 -0000
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11 61 1 090M- 11- 4 3 03's pl,
NATURE OF WORK STRUCTURE
Storm Repair Primary Structure
PROJECT NAME PERMIT EXPIRES 09/1812016
551 N10thSt- 140919 -Storm Damage 2014
ESTIMATED COMPLETION DATE 10/1512014
DESCRIPTION OF WORK
Roofing and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 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 Zconstlitsufficient ground for the revocation of any permit issued which was based on the approval of
this lication.
Signature of Applicant Date