HomeMy WebLinkAboutPL 1978-1469 New Single Family n
FEE SCHEDULE Permit No. 1 41,9 C I
CITY BLDG. r=7( •00 CITY OF OAK PARK HEIGHTS Plan No.
`tea (For Dept. use only)
STATE SURCHARGE
BLDG. PERMIT GO
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. fQ — � 19 -7(1
UTILITY CONNECTION Da }R / 7�
TOTAL AMOUNT DUE �� �� `� Cr/
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUF]B. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES —^ I II`�I LI
BY X IAI
Owner y:'� Address j L ? q q — ( --9 2 1a-L'" - S -
Architect UU Address
Giro} -Contractor Address
Contractor Reg. No.
NUMBER STREET ��� t SIDE BETWEEN WHAT CROSS STREETS
� -�
I'-f ill � J �T
LOT BLOCK ADDITION OR TRACT
g t 6- 61---
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH I HEIGHT 'NO. OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
YES DETAILS OR REMARKS: ll.
BASEMENT O 7-e-,,,,:,---r)
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 City of Oak Park Heights. Contractors must register with the village before permi .n be is -d.
OWNER /CONTRACTOR SIGNED '- - ' �� ,
OK'D BY