MS-2015-00800_0001.tif i
CITYOF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
L.,
Building rmi$Application (402)426-4191 - Phone
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mise of a www.blairnebraska.org
09/18/2015 bpeterse MISC Residential September 18,2015
s LOCATION OF IMPROVEMENT: 1068 Park St, Blair, NE 68008
ARCHITECT:
GENERAL Country Glass Inc.
OWNER: Dean W And Rita S Stacy CONTRACTOR:
6527 Co Rd P35
k 97 3rd Ave
BLAIR,NE 68008-0000
MALVERN,IA 51551-0000
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NATURE OF WORK
Storm Repair PERMIT EXPIRES
PROJECT NAME
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09/17/2017
1068ParkSt-150918-2014 Storm Damage 12/31/2015
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Re-roof with asphalt shingles.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
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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
act with or without the intention of the undersigned or any alteration or change from this application without approval of the
l B 'Iding Officieh s all nsi u sufficient ground for the revocation of any permit issued which was ba". on the approval of this
ap licatif v_ ."._._...
Si tarn`o A plie ate