HomeMy WebLinkAboutPL 1976-1011 New Single Family FEE SCHEDULE Permit No. /Q 1/
VILLAGE BLDG. /25 00 VILLAGE OF OAK PARK HEIGHTS Plan No.
` SO (For Dept. use only)
STATE SURCHARGE c �[''�7� ) `
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BLDG. PERMIT / .��-+ 4 76/
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. /
UTILITY CONNECTION Date 1 7-g (Ci 1 �]L
99‘
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK ®, l I BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK S
IGN
SQUARES ( U
BY X _
Owner Q ff Z Address 1 4 ke)i 5 5 1 a- .)Th
Architect Address
General Contractor pr - R `C IN - Address 9 L) (.7bi-trt`A L IAA Q eJ
Contractor Reg. No. 0. \ ■r` r i- -e ., lv. es `4" h V
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
4 55# . A' Yl
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
fRUCTURE
0 YES DETAILS OR REMARKS: 5 k pr 4 n u S .
ASEMENT /
CI NO F1 O /Hi b /
he undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work in strict accordance with •
II 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 __.