HomeMy WebLinkAboutPL 1976-1133 New Single Family •
FEE SCHEDULE Permit No. t
VILLAGE BLDG. 11.0o VILLAGE OF OAK PARK HEIGHTS - Plan No.
STATE SURCHARGE (For Dept. use only)
BLDG. PERMIT tI
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. S.A r�
UTILITY CONNECTION D e 1 .— �C� 19'7
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK BUILD P HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SO BY X I U 1 U
• r � YZ. v rn w\
Owner alMIS �11D _ _ . Address
Architect Address
General Contractor p Gl -'C \ P ( q t_. Address CI r? (J GL�It�Q- ,� 4
Contractor Reg. No. V
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
❑ YES DETAILS OR REMARKS: ! � ��
BASEMENT / S
❑ NO
F 6/
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 can be issued.
OWNER /CONTRACTOR SIGNED
OK'D BY -