HomeMy WebLinkAboutPL 1973-594 New Single Family r �.
FEE SCHEDULE Permit No. q
VILLAGE BLDG. .=. 0 VILLAGE OF OAK PARK HEIGHTS Plan No.
�Q (For Dept. use only)
STATE SURCHARGE ' ""- �- �
BLDG. PERMIT Al,r o /
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. r�
UTILITY CONNECTION Date ....1/ 19
TOTAL AMOUNT DUE i
STRUCTURE USED AS
REFRG HAN
MARK BUILD PL . HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIG
SQUARES
1 1
BY X
Owner "Trlyy1
A ddress 1� 0 t —LEI,. e � ,
Architect Address n p n
Ge ea:aLC ontractor l P. " Address W ` J . � � �)'`^ k""`� -�«
Contractor Reg. No. Aft-s' fp ,.....''....'. D f 14
' L
j `
NUMBER i 6k, Mf-STREET SIDE BETWEEN WHAT CROSS STREETS
t 4 s A-h A-k- -1(L..
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
❑ 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.
OWNER /CONTRACTOR SIGNED
OK'D BY