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DUE DATE: NOVEMBER 4,2004 OMB No.0607-0094:Approval Expires 02/28/2007
FORM C-404 REPORT OF PRIVATELY-OWNED U.S.DEPARTMENT OF COMMERCE
(3.12.20041Economics and Statistics Administration
RESIDENTIAL BUILDING OR ZONING PERMITS ISSUED U.S.CENSUS BUREAU
Please mail OR fax this form to: 1. PERIOD IN WHICH PERMITS WERE ISSUED- OCTOBER 2004
U.S.Census Bureau
1.201 East 10th Street
rsonville,IN 47132-0001
1-800-438-8040
Please read instructions on
t back
I I I I I I, I I I I I I I I III I I I I II
the bof thisis form. I
For further assistance,call
1-800-845-8244 or go to I
www.census.gov/permitsfaq 0027556900 2 40401200410
27 556900 2 163 1 0 NVR
2.GEOGRAPHIC COVERAGE 378 33460
If your permit system had a coverage SE004450
change,mark(X)in the appropriate box,
provide an explanation in Section 6,then
continue with Section 3. JULIE A HULTMAN
0610 Permits no longer required to build COMMUNITY DEVELOPMENT OFFICIAL
new residential buildingsrFOR CITY OF OAK PARK HEIGHTS
14168 OAK PARK BLVD N PO BOX 29.7
052❑Permit office has merged with OAK PARK HEIGHTS MN 55082
another permit jurisdiction
053❑Permit office has split into two
or more jurisdictions
054❑Extraterritorial
jurisdiction/Annexation
(Please correct any errors in name,address,and 2112 Code)
3.NEW RESIDENTIAL BUILDINGS too
a.If no new residential permits were issued during this period,mark an(X)in the box and proceed to Section 4 —>El
Number of Valuation of construction
Type of structure Item No.I
Buildings I Housing units (Omit cents)
(11 . (2) 13) (41 (5)
b.Single-family ti on and
detached( ee definition on back)
101
(Exclude manufactured HUD 11 1, :r Q ,Q oo
inspected homes.)
c.Two-unit buildings 103
d.Three-and four-unit buildings 104
e.Five-or-more unit buildings 105
/j f.TOTAL-Sum of 101-105 109
4.ADDITIONS,ALTERATIONS Item No. Number of permits Valuation of construction(Omit cents)
AND RENOVATIONS TO It) 12) (3)
RESIDENTIAL STRUCTURES
434 3 1bl 5,000
5.ADDITIONAL INFORMATION ON INDIVIDUAL RESIDENTIAL PERMITS,FROM SECTION 3,VALUED AT
$500,000 OR MORE(lf more space is needed,please attach a separate sheet.)
Description Name and address of owner or builder Buildings Housing units Valuation on
construction
I1) 12) (3) (4) (5)
a.Kind of building
tie
Site address
111
b.Kind of building
120
Site address
121
6.COMMENTS(Continue on a separate sheet)
600
7. PERSON TO CONTACT REGARDING THIS REPORT a.Name
700JULIE A HULTMAN
b.Telephone Area code I Number c.Fax Area code I Number
�7tc (651) 1439-4439 EXT 240 720 (000) 1000-0000
:mail address a.Internet web address
730 JHULTMAN@CITYOFOAKPARKHEIGHTS. 740
See instructions on reverse side.