HomeMy WebLinkAboutBP 1976-1034 Residing "\
Permit No. (� ��
FEE SCHEDULE Plan No.
‘5:1*,,,,,, VILLAGE OF OAK PARK HEIGHTS (For Dept.use only)
VILLAGE BLDG.
STATE SURCHARGE � ''J_ (9�� .3' — 5 / Xvita_ /�J r� . -„� .
BLDG. PERMIT ' C /lX��",
VILLAGE UTILITY
vxTERNAL PLBG.- APPLICATION FOR PERMIT �,�
METRO S.A.C. 6 Date _ a 197+
UTILITY CONNECTION / ' ,/ ,
TOTAL AMOUNT DUE STRUCTURE USED AS
l
REFRG
HANG
BUILD PLUMBHEAT INSTALL ALTERRESIQE MOVE WRECK SIGN
MARK —
I REPAIR (11 I
SQUBAVRXES l 1 Il —
•-
�� &2-e,) Address .e..)3 : 64-4-}10„, c,...„,,..e_n .
Owner --
Aik •ddres
:: ontractor
/
/I . ��_' Vii ' 3
Contractor Reg. No.
NUMBER STREET
SIDE BETWEEN WHAT CROSS STREETS
6.3Q 2 10. ct„, 6..u._z_ n•
z,e...i
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
/1S-6
STRUCTURE 04
DETAILS OR REMARKS: ���_ �.
L.
❑ YES - /
BASEMENT ❑ NO 4 _ - _ — =
9.-- /V l
L
o
l work
T un•ersigned he by m kes o pl cation
k Heights. Contractorsgmust'reg soler withethenvsllage'ed,beforoerperm9ttcanobelissued'n strict accordance with
all ordinances of the Village of Oak ParOWNER/CONTRACTOR SIGNED -
OK'D BY a_ .� l._.�i_%`