MS-2015-00462.tif i
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CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
®
Building er It Application (402) 426 -4191 - Phone
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(402) 426 -4195 - FAX
MS- 2015 -00462 /Se of a www.blairnebraska.org j
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06/05/2015 ShellyJ MISC Residential June 5, 2015
LOCATIONOFIMPROVEMENT: 2514 College Dr, Blair, NE 68008
ARCHITECT:
® GENERAL. Nielsen Home Improvement
OWNER: Robert J, Amie Clausen, Cynthia Clausen CONTRACTOR:
' - Hansen 1023 W Superior
7513087 Us Hwy Missouri Valley, IA 51555
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE j
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 06/04/2017
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2514CollegeDr- 150605 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112015
DESCRIPTION OF WORK
Reroof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS 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 cod rdinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of j
fact with or withpu i enti n of the undersigned or any alteration or change from this application without approval of the
Building Offic' , shall stitut sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Signature of pplicant Date
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