1819 Colfax Application.tif CITYOF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
'PERMIT NUMBER Building Permit Application (402)426-4191 -Phone
AC-2015-00967 '0�0�, vo (402)426-4195-FAX
ase of a www.blairnebraska.org
11/24/2015 ACCESS Residential November24,2015
pit LOCATIONOFIMPROVEMENT: 1819 Colfax St, Blair, NE 68008
IN ARCHITECT: GENERAL SELF
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OWNER: Donald E Matzen CONTRACTOR:
1819 Colfax St Blair, NE 68008
BLAIR,NE 68008-0000
NATURE OF WORK STRUCTURE
New Construction Accessory Structure
PROJECT NAME PERMIT EXPIRES 11/23/2017
1819CoIfaxSt-151124-Accessory Building
ESTIMATED COMPLETION DATE 6/30/2016
DESCRIPTION OF WORK
Construct a new detached garage 36 x 24. Previous garage was removed.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
AFFADAVI
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
appl' ation.
Date
Signature of Applicant