HomeMy WebLinkAboutBP 1984-2212 Addition j4 —
FEE SCHEDULE �� I Permit No. ��
CITY OF OAK PARK HEIGHTS Plan No.
CITY BLDG. S- 439-4439 (For Dept. use only)
STATE SURCHARGE 7 may.
PLAN CHECK .3.� • ��
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION Date `") 1 94
TOTAL AMOUNT DUE </; _-
�s
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES �/
BY X /X
Owner AdPAddress
Architect / Address •
General Contractor_A, -2, -oddress
Contractor Reg. No. ,7.3 S!�Z
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 VALCE
STRUCTURE
BASEMENT
❑ YES ` �'� DETAILS OR REMARKS:
O NO
The undersigned hereby makes application for a permit to do Building Work as herein specified, agrceing do all rk in strict accordance with
all ordinances of the City of Oak Park Heights. Contractors must register with the village before permi cbe su
OWNER/CONTRACTOR SIGNED )C
OK'D BY