MS-2015-00744_0001.tif CITYOF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
Building Perit Application (402)426-4191 -Phone
MS-201 -®®7 �°,o (402)426-4195-FAX
mise of ao' www.blairnebraska.org
0812612015 MISC Residential August 27, 2015
LOCA'iTONOFIMPROVEMENT. 1802 Lincoln St, Blair,NE 68008
ARCHITECT:
GENERAL Complete Exteriors
g— OMER Scott Nelsen CONTRACTOR:
-`' 7805 L St
OMAHA,NE 68127
BLAIRNE, 68008-0000
1100 �ry
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/2512017
1802Llncolr5t-150826-2014 Storm Damage
ESTIMATED COMPLETION DATE 1 2131120 1 5
DESCRIPTION OF WORK
Re-roof with asphalt.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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 pians for this project must be submitted to the Nebraska State l=ire 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 codeslordinances 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
application.
2-T 1 r
Signature of Applicant Date
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