HomeMy WebLinkAboutPL 1979-1604 New Single Family FEE SCHEDULE
Permit No. /b 0
CITY BLDG, Q•{f CITY OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE Q (For Dept. use only)
BLDG. PERMIT /`C
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. (�
UTILITY CONNECTION Date 7/3 v' 19 /Y
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT • ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES IV I I7 U Fl B Y X Y A K
Owner /k '
= ) 5� �� Address Scq �
� Ca.c42—.) N
Architect Sc...f . Address J
General Contractor r ,,, sc.,JC. ° bell 1.'w.c_• Address /7 ix �e
.ii.7 AC"e� S71
ontractor Reg. No.
hair % 5'.3 - o $P-8
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
SC Fl 6 �`' _,,d.I t ,-
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NQ OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
O YES DETAILS OR REMARKS: .
BASEMENT )
NO y /
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 peryrian be issued .
OWNER /CONTRACTOR SIGNED} D ` -�
OK'D B`. , r — ? / �.✓