1234 S 16th St.tif i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
- Building Permit Application (402) 426 -4191 -Phone
Ago,,, �o`'`� (402) 426 -4195 -FAX
MS- 2015 -00611
/Se or a www.blairnebraska.org
Mill
07/29/2015 77 7M �- lsc Residential July 29, 2015
LOCATION OF IMPROVEMENT: 1234 S 16th St, Blair, NE 68008
ARCHITECT:
GENERAL BC Construction
OWNER: Margaret E H Trustee Martin CONTRACTOR:
5041 Co Rd 40
1234 S 16th St Fort Calhoun, NE 68023
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Misc. Permit Primary
PROJECT NAME PERMIT EXPIRES 01/2512016
1234S16thSt- 150729 - Driveway ESTIMATED COMPLETION DATE 7/30/2015
DESCRIPTION OF WORK
Replacement driveway
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 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
B -it fficial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app 1d do .
date
Sig n nature of Applic