HomeMy WebLinkAboutPL 1987-2654 New Single Family Dwelling Permit No.
FEE SCHEDULE Plan No.
CITY OF OAK PARK HEIGHTS (For Dept. use only)
CITY BLDG. [ / 4 J 39 - 4 1 439
STATE SURCHARGE
PLAN CHECK
C XTERNAERNA L PLBG. IT TV APPLICATION FOR PERMIT
E
METRO S.A.C. D ate
UTILITY CONNECTION ?
TOTAL AMOUNT DUE 1J 3 '1 Q STRUCTURE USED AS
HANG
REFRG ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK BUILD PLUMB Ha INS ❑ ❑ � [] a [] 0 [1 a
SQUARES r`i- \¢( -' /�''
BY X
Owner Address
Architect Address
�i Address �f fir) b
General Contractor `°s1AWAIQ� ��� `-- - -- - -- Sup +�3A
Contractor Reg. No. rn•
NUMBER STREET SIDE BETWEEN WHAT CROSS STR
y U� P
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
STRUCTURE
DETAILS OR REMARKS:
BASEMENT ❑ YES
❑ NO
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 permit can be & d.
OWNER /CONTRACTOR SIGNED
OK'D BY _