HomeMy WebLinkAboutPL 1976-1130 New Single Family •
FEE SCHEDULE Permit No. Van
VILLAGE BLDG. ,'S• 00 VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE rs (For Dept. use only)
BLDG. PERMIT CZ23-
VILLAGE UTILITY
EXTERNAL. PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION to l� ��� 19
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG. HANG
MARK BUILD PLUMQ. HEAT IN ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES 1 I
BY X l I l U •
Owner 114, n•`. Address
Architect n Address
General Contractor Q\O ' �_d.1. \.. Address 9 ( G-r 10 Q
Contractor Reg. No.
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 VALUE
STRUCTURE
DETAILS OR REMARKS:
o YES / � � o,.���.��yJ a< .5
BASEMENT Q O
NO
X69'
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 Village of Oak Park Heights. Contractors must register with the village before permit con be issued.
OWNER /CONTRACTOR SIGNED
OK'D BY