HomeMy WebLinkAboutPL 1976-979 New Single Family n
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FEE SCHEDULE Permit No. 1
VILLAGE OF OAK PARK HEIGHTS Plan No.
ILLAGE BLDG. i ` �� (For Dept. use only)
TATE SURCHARGE r / - Tin 1LDG. PERMIT ? yll
'ILLAGE UTILITY
'XTERNAI< PLBG. APPLICATION FOR PERMIT
IETROS.A.C. l� /� l r�,/
JTILITY CONNECTION Date 77.21¢
rOTAL AMOUNT DUE /
STRUCTURE USED AS
HANG
REFRG. ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK BUILD PLUMB. HEAT INSTALL 1 ^I
SQUARES I 1 I/` /y^f1 1 1 �.�
BY X
)wner J O lc o, k 142 Address
\ rchitect Address n i y
;eneral Contractor Qir
�,� Address e\ fl e"Q''r ` 12-el
:ontractor Reg. No.
JUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
I/ DNS SS 771 • S - i'•
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH
SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NO. OF STORIES TYPE OF CONSTRUCTION I ESTIMATED VALUE
RUCTURE
DETAILS OR REMARKS: i 7.� °
❑ YES I
1SEMENT ❑ NO
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 Pork Heights. Contractors must register with the village before permit can be issued
OWNER /CONTRACTOR SIGNED Ver.1 Y-Y1. e
OK'D BY