MS-2015-442_0001.tif CITYOF BLAIR
218 S, 16TH STREET
BLAIR, NEBRASKA 68008
, c „1 1� (402) 426 -4191 - Phone
- fi 5�' ti4 a (402) 426 -4195 - FAX
/se of n www.blairnebraska.org.
05/2912015 MISC Residential May 29, 2015
LOCATIONORMPROVEMENT: 1419 Grant St, Blair, NE 68008
ARCHITECT:
GENERAL Jorgensen Contracting, Inc.
OWNER: Matthew M And Sarah N Walsh CONTRACTOR,
530 Front St
1419 Grant St Blair, NE 68008
BLAIR, NE 68008-0000
LIM ME
NATURE OF WORK STRUCTURE
5 P ,i t a Tf 3 3 r it f Shit *' rIk
Storm Repair Primary residence
T
PERMIT EXPIRES 05128/20/7
1419GrantSt- 1519529 -2014 Storm Damage ESTIMATED O L.ETI LATE 1213112015
DE O F WORK
Replace roof, north and west walls, walk door, window of little bitty pole building garage.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING FLANS SUBMITTED: NA
$50
a
t
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 or witho t of the undersigned or any alteration or change from this application without approval of the
�idin 91 all co . titute s fficient ground for the revocation of any permit issued which was based on the approval of this
ap a
f
i9fiature of App ca Date
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