HomeMy WebLinkAboutPL 1982-2018 New Single Family FEE SCH DD LE Permit No. d
_DG. .S. 0-0 CITY OF OAK PARK HEIGHTS Plan No.
URCHARGE X5-0 04 I 0 iYN,(J(j (For Dept. use only)
=ERMIT ...SSIS-6
—ILITY
APLBG. APPLICATION FOR PERMIT
Q.A.C.
" CONNECTION
Date 10-(2-
AMOUNT
0(2—AMOUNT DUE
STRUCTURE USED AS
REFRG. HAN<
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
21 Li
____e_. /Ceie __. Address
_t•
Address
Contractor Address
--or Reg. No.
STREET SIDE BETWEEN WHAT CROSS STREETS
� r �
(9 / i f /
BLOCK I ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
WIDTH LENGTH HEIGHT ,NO.OFSTORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
it
❑ YES DETAILS OR REMARKS: -12-'4- --7
❑ NO
mgned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work in strict accordance with
zes of the City of Oak Park Heights.Contractors must register with the village before rmi can be issued
OWNER/CONTRACTOR SIGN d- edF
OK'D BY_