HomeMy WebLinkAboutPL 1972-480 New Single Family l""\
• S �-. Permit No. ... Q
$ 4 v (Building) VILLAGE OF OAK PARK HEIGHTS Plan No.
TOTAL FEE COLLECTED (For Dept, use only)
DOUBLE FEE COLLECTED
ACCOUNT ORDINANCE
VIOLATION
(MARK X IN SQUARE)
APPLICATION FOR PERMIT
Date 2' 19
To:
STRUCTURE USED AS
REFRG. HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES �/ I
BY X U
Owner jilIA- -Sa r. �-� Address /% <V 4 A)
Architect /� Address /
General Contractor !/111�M _ Address 7/ L- �'. /d' /6X /
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
f_1 5 7/ Sl A).
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
O YES DETAILS OR REMARKS:
O NO /d 1)X IecC
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 befo'termit c be i ed.
SIGNED
B / .L