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FEE SCHEDULE ///4P i Permit No. .2C-0
S CITY OF OA' PARK HEIGHTS Plan No.
CITY BLDG. _ 439-4439 (For Dept.u.e only)
STATE SURCHARGE Ace.)
PLAN CHECK
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. .p
UTILITY CONNECTION Date_ �/ �' �"'— 19 G1
TOTAL AMOUNT DUE aZ , S STRUCTURE USED AS
REFRG HANG
SIGN
MOVE REROOFWRECK
ALTER REPAIR
MARK BUILD PLUMB. HEAT INSTALLIR RESIDE
SQUARES1BY X
_ - oISL o
•
Owner Address
/
Architect Address
General Contractor Address
Contractor Reg. No.
** NO CONSTRUCTION TO START PRIOR TO 7:00 A.P- . **
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 OFSTORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
BASEMENT
0 YES DETAILS OR REMARKS:
NO
The undersigned hereby makes application for a permit to do Building Work as herein specified,agreeing to do all work in strictt accordance with
all ordinances of the City of Oak Park Heights.Contractors must register with the village before permit ca i •
OWNER/CONTRACTOR SIGNED
OK'D BY_