HomeMy WebLinkAboutPL 1979-1641 New Single Family FEE SCHEDUL /63/./ Permit No/63/./ CITY BLDG. kr I I CITY OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE rS� _ G j/ `� l/ ir/✓ (For Dept. use only)
BLDG. PERMIT ' � J �f vn / L = //✓ r ��)j�rM Z�G�r��
CITY UTILITY
EXTFRNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION Date ! /
- 3. 19
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG
MARK BUILD /P�pLUUMB. HEAT INSTALL -- ALTER REPAIR REROOF RESIDE MOVE WRECK S HANG
SQUARES El (/�---� J 0 E a
Owner -- Address
Architect Address
General Contractor ClAM/E1 Err S. Address /Y77 3 ,f " /.? s).‹.
Contractor Reg. No. RA- 1 .k4 g PLR
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
/772? 5
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:
YES
BASEMENT
0 NO 6.- S'
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 p it can be issued.
OWNER /CONTRACTOR SIGNED l .d.a
OK'D BY