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Permit 4/7
CITY OF OAK PARK HEIGHTS Plan No.
CITY BLDG. / • O `3 439-4439 (For Deptuse only)
STATE SURCHARGE 1- • ��j
PLAN CHECK / .St ys
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
Date v 1 Py
UTILITY CONNECTION
TOTAL AMOUNT DUE 3 3.3r yS` STRUCTURE USED AS
REFRG HANG
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK '/ 1 l
SQUARES I '
BY X
Owner >1 ' S ' /1. Address
Architect Address
General Contractor Address
Contractor Reg. No.
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 OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
p YES DETAILS OR REMARKS:
BASEMENT O NO
C \ .LL, 460 l .e.IA J
The undersigned hereby makes application for a permit to do Building Work as herei specified, agreei 1! to do all work in stri •ccordance with
all ordinances of the City of Oak Park Heights. Contractors must register with the vil''"((((age before permit be issue d • e
i
OWNER/CONTRACTOR SIGNED J t
r OK'D BY