MS-2014--03012.tif i
CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
„� �� (402) 426 -4191 - Phone
Building Permit Application
lea (402) 426 -4195 -FAX
MS-2014 -03012 �p'�n,;se of (:k- oNl www.blairnebraska.org
10/09/2014 bpeterse 7! 71 Residential October 9, 2014 77
LOCATIONOFIMPROVEMENT: 2160 Crestridge Dr, Blair, NE 68008
, ARCHITECT: GENERAL Humble Works, LLC
OWNER: Clifton 0 Jr And Belinda A Thrash
CONTRACTOR:
15218 Adams St
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2160 Crestridge Dr Omaha, NE 68137
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Fence Primary Residence
PROJECT NAME PERMIT EXPIRES 10/08/2016
2160CrestridgeDr- 141009 -Fence 71/1/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Replacing hail damaged 6' fence with 4' pvc fence. To enclose backyard.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: 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 Offic shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Date
Signature of Applicant
CITY OF BLAIR, NEBRASKA
Phone 402- 426 -4191
RECEIVED OF:
ADDRESS
CITY, STATE, ZIP CODE
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T HANK YOU KEEP THIS.COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
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promise
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any r
residential, and any additions, remodels and accessory build
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for and
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. pi
The City reserves the right to not refund this deposit if
conditions occur during the construction period:
1) Theft of water service by the plumber, owner or get
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection.
5) The project is completed without a final inspection I
6) Storm Water Management Plan inspection not obt-,
If any or all of these situations occur during construction,
deposit.
I hereby agree to the above conditions, and understi
all of the above situations occur, the building permit deposit
discounted upon the discretion of the City of Blair, Bui
Department.
Contractor /Owner Contractor /Owner
C
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FENCE PERMIT SUPPORTING DOCUME
This supporting document includes information dealing
requirements and /or fence permit requirements. It in no wad
zoning items. Also, it is your responsibility to know the City of
Section 1102 requirements that apply to fences, walls and he
this document is only designed and distributed to aid in your
copy of the City of Blair Zoning Ordinance is available for yo
Library or on our website at www.blairnebraska.org
I have read the above disclosure and accept this building per
own behalf assuming full responsibility as the owner /contractor
4 e- 1 r-
Owner /Occupant Contractor