HomeMy WebLinkAboutBP 1975-934 Chimney FEE SCHEDULE Permit No. 9 3
VILLAGE BLDG. � DO VILLAGE OF OAK PARK HEIGHTS Plan No.
So (For Dept. use only)
STATE SURCHARGE /
BLDG. PERMIT `?•'J 0
VILLAGE UTILITY
EXTERNAI. PLBG. APPLICATION FOR PERMIT
METRO S,A,C. 7rn�
UTILITY CONNECTION Date
, 1�
TOTAL AMOUNT DUE I �pQ
1111 STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT INSTALL ALTS REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
BY X
Owner Address '1 l CkAi-de\
Architect Address
General Contractor `(`(1Address
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
5.0 t Lu
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 ilOa as
❑ YES DETAILS OR REMARKS:
BASEMENT ❑
NO
The undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work instrictaccordance with
all ordinances of the Village of Oak Park Heights. Contractors must register with the village befllre�pcan be is @Xy
OWNER/CONTRACTOR SIGNED C/V/�
OK'D BY