HomeMy WebLinkAboutPL 1973-624 New Single Family AI . Do 1 Permit No. AV
$ i. SD (Building) VILLAGE OF OAK PARK HEIGHTS Plan No.
TOTAL FEE COLLECTED (For Dept. use only)
DOUBLE FEE COLLECTED
ACCOUNT ORDINANCE
VIOLATION
(MARK X IN SQUARE)
APPLICATION FOR PERMIT
Dat= ( .. 9
1
To: STRUCTURE USED AS
REFRG. HANG
MARK BUILD P Uty tB HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES Lf
BY X
Owner kj. oy. p Address
Architect Address + � �
Geflervi-Contractor Address •+•� ' 1 7 0
Contractor Reg. No. J Q L. eA -4)
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
14 g . 4ri let
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
BASEMENT
CI YES DETAILS OR REMARKS: (
❑ 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 before permit can be issued.
SIGNED
BY