ms-2015-267_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
1 mit Application
(402) 426 -4191 -Phone
Building @ j
(402) 426 4195 - FAX
www.blairnebraska.org
MS- 2015 -00267 ar o o+ a�
i
04/17/2015 bpeterse MISC 777 Residential April 17, 2015
1 LOCATIONOFIMPROVEMENT: 9791 Squirrel Ln, Blair, NE 68008
r gy�r
° t p
:f ARCHITECT:
GENERAL Monarch Siding &Windows Inc.
OWNER: Ann L And Patrick C Co Trustees Nichols CONTRACTOR:
� 308 E Cary St c
9791 Squirrel Run PAPILLION, NE 68046
BLAIR, NE 68008 -7575
'YO
rl•` a
2 f
y..
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PERMIT EXPIRES 04/1612017
PROJECT NAME
I
9791SquirrelLn- 150417 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2015
DESCRIPTION OF WORK
Re -roof, siding west side.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: 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 accord 'ice 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 O hall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appli at'oh.
Date
Signature of Applica t