HomeMy WebLinkAboutPL 1976-1046 Drainfield Work -....\ A."1
Permit No. 1 b 4-6
FEE SCHEDULE VILLAGE OF OAK PARK HEIGHTS Plan No.
VILLAGE BLDG. `CrO (For Dept.use only)
STATE SURCHARGE ° S-f)
BLDG. PERMIT . --*—Sr.)
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT '�/
METRO S.A.C. D e Dia 19-1(0UTILITY CONNECTION
TOTAL AMOUNT DUE STRUCTURE USED AS
HANG
RE FRG ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK BUILD PLUMB. HEAT INSTALL I 1 I I I1
SQUARES1 H H I J
BY X
Owner aiicv, N,...,,--lai ),4_, Address
5'`
Q O &k " -
Architect Address
�'
General ContractorIL `� tfG2v'� ress 0 9
Contractor Reg. No.
NUMBER
STREET SIDE BETWEEN WHAT CROSS STREETS
SXI a. /-*CLCI__Qtfa-A-9\ •.3-4 ..k3.--j
ADDITION OR TRACT
LOT BLOCK
WIDTH DEPTH
SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NO.OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
,..+
STRUCTURE 9a4,C,/OOv
DETAILS OR REMARKS: I Q
o
BASEMENT YES
Cl NO
The undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all w k in strict accordance with
all ordinances of the Village of Oak Park Heights. Contractors must register with the village b ore permijrSfufd.
OWNER/CONTRACTOR SIGNED ,,'s-s t
OK'D BY '