HomeMy WebLinkAboutPL 1973-596 New Single Family n
FEE SCHEDULE Permit No. �/ L
VILLAGE BLDG. r'% / *CIO VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE
'SD (For Dept. use only)
/'^ � p BLDG. PERMIT Cam J
VILLAGE UTILITY
EXTERNAL, PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION D psi 19
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLU B. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
-
BY X
Owner _J u "r0–.0 Address / ' 22. f — 5-40
Architect Address
C,ei erai-Contractor �_:�_ yi Address r- A
Contractor Reg. No. € 2- - `e;r1.912)
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
,WSW/ 74A /g
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
DETAILS OR REMARKS:
BASEMENT ❑ YES
❑ 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