MS-2015-00036_0001.tif i
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
Building Permit Application
-����, (402) 426 -4195 - FAX
MS -2015 -00036 '� o� Quo www.blairnebraska.org
01127/2015 bpeterse MISC Residential January 27, 2015
LOCATIONOFIMPROVEMENT: 3071 Westridge Dr, Blair, NE 68008
ARCHITECT:
GENERAL Welter Construction LLC
OWNER: Matthew E And Jill E Johnson CONTRACTOR:
6.1`r
8140 Arthur St NE Ste I
v 2071 Westridge Dr Spring Lake Park, MN 55432
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 01/26/2017
3071 WestridgeDr- 150127- 2014Storm ESTIMATED COMPLETION DATE 4/27/2015
Damage
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DESCRIPTION OF WORK
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Siding -Board and Batten siding.
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 w' or 'thout the intention of the undersigned or any alteration or change from this application without approval of the
Build' g O,ffiefal, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appli ion.
Signature of Applicant Date