HomeMy WebLinkAboutPL 1975-912 New Single FAmily ''ll Permit No.
$ c J. • . v (Building) VILLAGE OF OAK PARK HEIGHTS Plan No.
TOTAL FEE COLLECTED
(For Dept. use only)
DOUBLE FEE COLLECTED ^
ACCOUNT ORDINANCE 1L
VIOLATION
(MARK X IN SQUARE)
APPLICATION FOR PERMIT _
Date . t _ ' a3 19
_ -
To: STRUCTURE USED AS
REFRG. HANG
MARK BUILD PLU HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES I 1 LI J
BY X U
Owne I 4 66 9 -. 14/. )Z
r 1,dCJt 1'l Address r--
Architect Address
eienecal- Contractor eitit Address
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
NC ? -.-- >_1. Z.
LOT BLOCK ADDITION OR TRACT
/ 6 C -
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NQ OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
❑ YES DETAILS OR REMARKS: __ )
BASEMENT 9
❑ 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 efo permit can be i ed.^ J�/
SIGNED
BY