HomeMy WebLinkAboutPL 1976-1012 New Single Family n ^,
FEE SCHEDULE Permit No. / i l c
VILLAGE BLDG. c�-3 •Ud VILLAGE OF OAK PARK HEIGHTS I Plan No.
STATE SURCHARGE ' (For Dept. use only)
BLDG. PERMIT c s 3 ,,s y , �/�
VILLAGE UTILITY •i+ v
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION
Dam 1:- /— -gie 1n,�
TOTAL AMOUNT DUE 7 ��` J%
l.s0
STRUCTURE USED AS
REFRG
HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WR S SIGN
SQUARES fl fl fl 17 E a
BY X
Owner W c)`r`. •r.., C, i 4k 1
Address � l'
Architect Address
General Contractor R --rn `\ `C'l.,lr, "\'1‘c Address gel /49) r 4Id n %,q -,-".
Contractor Reg. No. (° 1 v'ci, P R VX S ' Y N A-1/101, lit
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
�-- 7 �
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NO. OFSTORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
- RUCTURE
kSEMENT 0 YNO DETAILS OR REMARKS: Q U �,�\.� fa�3.s5
ie 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 Park Heights. Contractors must register with the village before permit can be issued.
OWNER /CONTRACTOR SIGNED
OK'D BY