HomeMy WebLinkAboutME 1973-655 New Single Family FEE SCHEDy Permit No. ea .5
VILLAGE BLDG. a(o�S VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE
1S0 (For Dept. use only)
BLDG. PERMIT , Po --7 7..; r
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. r�
UTILITY CONNECTION Date /o 19
TOTAL AMOUNT DUE I /
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. H T'S INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
BY X
ri
Owner r it ��^ �, Address I 1 Z _ — .D1 • 1
Architect Address >
General Contractor (1 ..._: I Q(A1U ;: •
._ r Address Cck. --�.� — E. 0 'v`.< '
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
1 L F LO \ f" \... •
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NO OFSTORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE /Q % S ��
BASEMENT
❑ YES DETAILS OR REMARKS: PS BTU
❑ NO
The undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work in strict ccordance with
all ordinances of the Village of Oak Park Heights. Contractors must register with the village re pe it an�ssued.
OWNER /CONTRACTOR SIGNED ���
OK'D BY