MS-2014-03178.tif I
CITYOF BLAIR -
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
9 ,�x (402) 426 -4195 - FAX
MS -2014 -03178 p ` °anis of a� www.blairnebraska.org
10/28/2014 intern MISC Residential October 28, 2014
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LOCATION OF IMPROVEMENT: 2400 Hollow Rd, Blair, NE 68008
ARCHITECT:
GENERAL Denny Roofing
OWNER: Sue Atkinson CONTRACTOR:
2400 Hollow Rd
2400 Hollow Rd Blair, NE 68008
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BLAIR, NE 68008 -0000
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W10-11117
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 10/27/2016
2400HollowRd- 141028 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roof, siding, gutters, windows
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 L
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
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