HomeMy WebLinkAboutPL 1976 New Single Family FEE SCHEDULE , Permit No. /v t 6
VILLAGE BLDG. t -O VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE
b (For Dept. use only)
BLDG. PERMIT a3 .,7o ,��,
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT q , �
METRO S.A.C.
UTILITY CONNECTION D e �-�
_
19
TOTAL AMOUNT DUE ^ ^ .LA ��
l/ STRUCTURE USED AS
REFRG HANG
BY
BUILD PLUMB. HEAT INSTALL I TAL I C ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES U Ir U
110' • 1, '
Owner - - - - -_ -_-.. • � Address
.\ US
Architect Address
General Contractor R 4- W1 P. T (. bo 1 G Address C1 ( `7 Lc) C}-a --Qek . ' L Oct
Contractor Reg. No. �
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
) 2H96 c.,s J -PY1
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NQ OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
DETAILS OR REMARKS: 3,
BASEMENT ❑ YES /4 7p
❑ NO / Q
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