MS-2015-00124.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426-4191- Phone
(402) 426 -4195 - FAX
MS- 2015 -00124 ise at C P www.blairnebraska.org
03/11/2015 bpeterse MISC Residential March 11, 2015
LOCATIONOFIMPROVEMENT: 1993 Crestridge Dr, Blair, NE 68008
;< ARCHITECT: GENERAL Berens Construction Inc
OWNER: Swerczek Ii, Robert A and Kathleen s CONTRACTOR:
428 Bryan Cir, Ste 200
1993 Crestridge Dr GRETNA, NE 68028
BLAIR, NE 68008 -0000
77 .:- _ � .,T.- �,;-�. r,:. ,. ;s. 0 .
VIN n ...,..
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES
03/10/2017
1993CrestridgeDr- 150311- 2014Storm ESTIMATED COMPLETION DATE 12/31/2015
Damage
DESCRIPTION OF WORK !
Vinyl siding and gutters.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
ME
s
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 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
�lic�tio
Date
Signature of A ant