MS-2015-00176_0001.tif 7
CITYOF BLAIR I
218S.16THSTREET
BLAIR, NEBRASKA 68008
Buil Per Applic (402) 426 4191 -Phone
IIIIS -2015 -00176 �° ,,��'�' (402) 426 -4195 - FAx
e of a www.blairnabraska.org i
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03/19/2015 bpeterse MISC Residential March 20, 2015
LOCATIONOFIMPROVEMENT. 13087 US HWY 75, Blair, NE 6$008 j
ARCHITECT:
GENERAL Jorgensen Contracting, Inc.
OV1R: Dick Hansen CONTRACTOR:
530 Front St
13087 U.s. 75 Hwy Blair, NE 68008
Blair, NE 68008
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NATURE OF WORK STRUCTURE
Storm Repair Accessory Building
PROJECT NAME PERMIT EXPIRES 03/1912017
13087Us 75Hwy- 150319 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2015
DESCRIPTION OF WORK
Replace roof, cupola, west and north wall metal and 2 north overhead door panels
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS:
BUILDING PLANS SUBMITTED: NA
$60
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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 g g g g 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 I
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 codesiordinances 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
pi din Official, shall c itute s ient ground for the revocation of any permit issued which was based on the approval of this
applic
? 9a " ture of Applicant Date
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