HomeMy WebLinkAboutPL 1981-1821 New Single Family FEE SCHEDULE Permit No. / ._
CITY BLDG. . E 3 /.0 CITY OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE . S D (For Dept. us only)
BLDG. PERMIT 51,SQ e
CITY UTILITY
T PLBG. APPLICATION FOR PERMIT
METRO S.A.C. S.A
UTILITY CONNECTION
TOTAL AMOUNT DUE
1 1 t 1 , I
� ,141 /i Yt
Date / — �2 19
STRUCTURE USED AS
REFRG
BUILD PLUMB. HEAT INSTALL
MARK (� I ALTER REPAIR REROOF RESIDE MOVE WRECK SA
L A
SQUBY 4RES X I 1 11 IV I I fl n n n f LJ
/ / \�
Owner 1j , t9 P / Address
Architect / Address
General Contractor W.4 I.4/a.,. j Address
C7tre,ctor Reg. No.
NUMBER STREET SIDE
BETWEEN WHAT CROSS STREETS
2n ...5
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 ' DETAILS OR REMARKS: I f 3 P/ ,,,i)
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 permit can be issued.
OWNER /CONTRACTOR SIGNED
OK'D BY
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