HomeMy WebLinkAboutPL 1976-1032 Remodel "res
FEE SCHEDULE/ b
Permit No. \ � D1
/
VILLAGE BLDG. /• 00 VILLAGE OF OAK PARK HEIGHTS Plan No.
(For Dept. use only)
STATE SURCHARGE : J^/�
BLDG. PERMIT itJ_d
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. � 7r�y/�
UTILITY CONNECTION Date�..�)'T'— 1S 1n9 `L
TOTAL AMOUNT DUE l/V ', �— x
STRUCTURE USED AS
REFRG HANG
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK
SQUARES 5 ,
BY X
Owner U) w(1-.J '- C\1�►�l) 0, °410-0-4
Address 9 0 �'w't h
Architect Addressn _ -^- (,(
General Contractor . 4) Address )-{,t, '`v -" c'Qr
Contractor Reg. No. < r. )
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
LOT BLICK 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 C---7•...)3ASEMENT ❑ NOS th4----A..Z� 7 .
The undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work in strict accordance with
all ordinances of the Village of Oak Park Heights. Contractors must register with the village befo it can be issued.
OWNER/CONTRACTOR SIGNED Af'7 ?Th
OK'D BY