HomeMy WebLinkAboutPL 1975-901 New Single Family oZ3 - o 40 /
Permit No.
$ , Q3 `s (Building) VILLAGE OF OAK PARK HEIGHTS Plan No.
(For Dept. use only)
TOTAL FEE COLLECTED
DOUBLE FEE COLLECTED n
ACCOUNT ORDINANCE
VIOLATION
(MARK X IN SQUARE)
APPLICATION FOR PERMIT
D I cg it j 9 2:1
T0: STRUCTURE USED AS
REFRG. HANG
MARK BUILD PLU B. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
BY X
Owner A— • — Address
Architect Address
General Contractor �' � C ' t1 vk-R ?1, bn • Address '/7 (II Ii -n Let AA-K RI
Contractor Reg. No. .- 6'SS
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
g vSi Sr
LOT BLOCK ADDITION OR TRACT
A EMI , • .
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NO. OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
BASEMENT
❑ YES DETAILS OR REMARKS:
❑ NO /O
(
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.
SIGNED
_. BY —