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MS-2015-00084_0001 (2).tif I - -' CITY OF BLAIR f J 218 S. 16TH STREET BLAIR, NEBRASKA 68008 !� liC tl (402) 426 -4991 - Phone - � 5 - �1 � A'o` � (402) 426 -4195 - FAX +3s <A .blairnebraska.org 02/24/2015 MISC Residential February 24, 2015 LOCATIONOFIMPROVEMENT: 11151 Co Rd P29, Blair, NE 68008 ARCHITECT. GENERAL Jorgensen Contracting, Inc. OWNER: Ann M, Quick, Randall D Wolsmann CONTRACTOR: 580 Front St 11127 Co Rd P29 Blair, NE 68008 B'LAIR, NE 68008 -0000 i i NATURE OF WORK STRUCTURE Storm Repair Primary Residence PROJECT NAME PERMIT EXPIRES 02/23/2017 11151 Co Rd P29 - 150224 -2014 Storm Damage ESTIMATED COMPLETION DATE 5/24/2015 i DESCRIPTION OF WORK Replace northwest galls and roof of pole building - Metal and trim. DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA Contractor REScheck/COMcheck SUBMITTED: NA DEPOSIT STATUS: BUILDING PLATS 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 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 9pplication without approval of the uildin Offi ial, shall co e suffice nt d for the revocation of any permit issued which was based on the approval of this applic n. SI ature of Applicant Date I I i