HomeMy WebLinkAboutPL 1976-1134 New Single Family FEE SCHEDULE Permit No. k, ��-
VILLAGE BLDG. < 00 VILLAGE OF OAK PARK HEIGHTS Plan No.
\ (For Dept. use only
STATE SURCHARGE � til
BLDG. PERMIT • \v
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. r � /�
UTILITY CONNECTION D to l� `—'�- 197
TOTAL AMOUNT DUE c�'�- �,..____�
STRUCTURE USED AS •
REFRG HANG
MARK BUILD PL HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES 1 _ LJ
BY X \ l
Owner Address
Architect Address
General Contractor (Ra - tm ai..._ lQ ..1 '..e - _ Address f A \ G ,-.4n ,,.. ,.1& Pte_
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
4L/ 39-, 65
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
RUCTURE
DETAILS OR REMARKS:
■SEMENT ❑ YES
❑ NO
q 7
le undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work in strict accordance with
I 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 —