HomeMy WebLinkAboutPL 1976-1135 New Single Family •
Permit No. 10 5
FEE SCHEDULE
VILLAGE BLDG. rq•3. C7 VILLAGE OF OAK PARK HEIGHTS Plan No.
So (For Dept. use only)
STATE SURCHARGE r
BLDG. PERMIT
VILLAGE UTILITY
XTERNAL, PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION
TOTAL AMOUNT DUE `v'`w' )
STRUCTURE USED AS
REFRG HANG
BUILD PLUMB HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK r
SQUARES
BY X
Owner Address
Architect -n n Address
General Contractor 11 --V\L Address C 7 ( i ) 6 Ae0n C P-1
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
1 . 14/4' b s '
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
O YES DETAILS OR REMARKS: r� 62r- ,'1Lvt..4-'4'
BASEMENT 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 Village of Oak Park Heights. Contractors must register with the village before permit can be issued.
OWNER /CONTRACTOR SIGNED
OK'D BY -