HomeMy WebLinkAboutPl 1973-616 New Single Family FEE SCHEDULE Permit No. 6/4
VILLAGE BLDG. /, • o O VILLAGE OF OAK PARK HEIGHTS Plan No.
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STATE SURCHARGE (For Dept. use only)
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BLDG. PERMIT
VILLAGE UTILITY
EXTERNALPLBG. APPLICATION FOR PERMIT
ME
METROROS.A.C.S.A1 1
UTILITY CONNECTION Date 2 I(7
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG
HANG
MARK BUILD PMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES IlY\X\}r
BY X
Owner --��� — �� + Address CGI XS-- ) !
Architect Address
General Contractor Address
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
/75. ' 6€/ . ,
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
BASEMENT
0 YES DETAILS OR REMARKS: C
❑ NO
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 re permit AD•e ued
OWNER/CONTRACTOR SIGNED
OK'D BY