HomeMy WebLinkAboutPL 1976-1091 Remodeling - Dentist Office •
FEE SCHEDULE Permit No. /0q/
VILLAGE BLDG. j \.G® VILLAGE OF OAK PARK HEIGHTS Plan No.
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STATE SURCHARGE ` (For Dept.use only)
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BLDG. PERMIT .1 - 2
VILLAGE UTILITY . .3o3
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. /;
UTILITY CONNECTION Date 7 3 1974,
TOTAL AMOUNT DUE
�� STRUCTURE USE S
REFRG. HANG
MARK BUILD PLUMS. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES I^I
BY XX.
Owner I LI LAA' �,��. Address CLS CL.t"1/44,_
Architect r Address
General Contractor R R- �(Y1 �} R P L 11�1: 1 ri c , Address Cj ? ( ,�Q,
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
9
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NO.OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
'RUCTURE
kSEMENT O No DETAILS OR REMARKS: o
YES
�c a�cc� �/. S
ie undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work in strict accordance with
I ordinances of the Village of Oak Park Heights. Contractors must register with the village before permit can be issued.
OWNER/CONTRACTOR SIGNED
- OK'D BY