HomeMy WebLinkAboutPL 1975-952 New Single Family FEE SCHEDULE Permit No. qJ 1
VILLAGE BLDG. 2 • 00 VILLAGE OF OAK PARK HEIGHTS Plan No. 1
STATE SURCHARGE r . 7 0 �'^ `` (For Dept. use only) 1
BLDG. PERMIT �1 "J�
VILLAGE UTILITY
EXTERNAI PLBG. APPLICATION FOR PERMIT
METRO S.A.C. J'� "' (1
UTILITY CONNECTION '''' D ` U Q-e1 19�_-
TOTAL AMOUNT DUE . U C
L,• 4
STRUCTURE USED AS
i 7 D
REFRG. HAN.
MARK BUILD P U HEAT INSTALL _^ ALTER REPAIR REROOF RESIDE MOVE WRECK SIG
SQUARES I yl E
BY X IYYY/--- �'YYYI
� �
Owner
�% . .■ ` -Ilk., Address �S
Architect ‘ Address
General Contractor �A 6w' Address Address / 7 Ltd (T 0--..e.,/, 4 p gd
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
i y55 y 6 fre;
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 ❑
NO #4/0 e h / f'1 C
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 1 / � ` ���
OK'D BY /,- 7 .L�,
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