HomeMy WebLinkAboutME 1976-1105 Boiler Replacement FEE SCHEDULE Permit No. //J..
CITY BLDG.. AV.00 CITY OF OAK PARK HEIGHTS Pion No.
STATE SURCHARGE ,J t (For Dept.use only)
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SLOG.PERMIT LIC /_i � e
CITY UTILITY (A
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PLBG. APPLICATION FOR PERMIT
METRO S.A.C. 1 r� �
UTILITY CONNECTION Date /6/i/ IT
TOTAL AMOUNT DUE
STRUCTURE USED AS
REPROHANG
MAIRX BUILDPLUMB. HINSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK� SIGN
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SQARE$ n `F+f III IC U
Owner t/L'v""vc& ,t J_-OG. Address 6 /13 ,i2L"6'4),A=4:d/7.
Architect �j� q[� n Address y� �/
General Contractor 41-4.1ri-c. i�//ti�-' (1O• Address 0'7 ) /• a�=� •6K—•
Contractor Reg.No. U
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
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
STRUCTURE
0 YES DETAILS OR REMARKS: I q
/� � /
BASEMENT LJ NO
/4'O 000 077i -9'I a c
The undersigned hereby makes application for a permit to do Building Work as herein specified,a eeing to do all work in strict ac rdance with
all ordinances of the City of Oak Park Heights.Contractors must register with the village before permit can be issued.
OWNER/CONTRACTOR SIGNED
OK'D BY