MS-2015-00384.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
II 111 Pe App lica t ion (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
- 2015 -00384 /se of www.blairnebraska.org
i
05114/2015 MISC Residential May 15, 2015
I
LOCATIONOFIMPROVEMENT: 575 S 16th St, Blair, NE 68008
ARCHITECT. GENERAL Acreage Fences
: x OWNER: Leroy J And Jane E Gramke Stevens Stevens CONTRACTOR:
8635 Military Rd
575 S 16th St Omaha, NE 68134
BLAIR, NE 68008 -0000
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NATURE ®F W ® RK STRUCTURE '.
Fence Primary Residence
PROJECT NAME PERMIT EXPIRES 0511312017
575S16thSt- 150514 -Fence
ESTIMATED COMPLETION DATE 6/1412015
DESCRIPTION OF WORK
6' tall pvc to enclose backyard with 3 gates. Will be on property lines.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
h
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
ation.
2J/y1-- 0
signature of Applicant Date
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OFA
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Ar
ADDRESS
CITY, STATE, ZIP CODE
(6121
Q.-
1100'
434
15. C
THANKYOU ('K EPq FOR YOUR RECORDS.
ND 39566 4RE ED R
BY
Pounds Printing, Blair, NE 68008