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HomeMy WebLinkAbout1976-1110 Gas Piping • • • FEE SCHEDULE Permit No. /1 1 D /� CITY BLDG,. ADO CITY OF OAK PARK HEIGHTS Plan No. �►y� (For Dept. use only) STATE SURCHARGE 4 J v � ` � rn BLDG. PERMIT �/ • •S CITY UTILITY EXTERNAL PLBG. APPLICATION FOR PERMIT METRO S.A.C. UTILITY CONNECTION Dat TOTAL AMOUNT DUE - y /,i © y � y f� _.L_� lam( Y STRUCTURE USED AS REFRG HANG MARK BUILD PLUMB. EAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN SQUARES BY X [ l -+ Owner a6- .2.irn.¢- r,v0.h-r, 1i4J- / ,,,z-Address 90 I 10Z7Q..AQJ rid (A'c 4 Architect / Address General Contractor■.�%�� .:•�r�lw" I •.• q... Address -P-P I Contractor Reg. No. • NUMBER &ry-let.Aa., STREET SIDE BETWEEN WHAT CROSS STREETS 590 1 &.u•-e- /7 Z 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 O STRUCTURE ❑ YES DETAILS OR REMARKS: �JQ' girt-4-72-4--7 BASEMENT NO ❑ 7^^���r I f r 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 City of Oak Park Heights. Contractors must register with the village before pe it can be issued. i / I OWNER/CONTRACTOR CONTRACTOR SIGNED A / %- - f . =J ��� 1....,...-4.„..... OK'D BY