HomeMy WebLinkAboutBP 1979-1589 New Single Family •
FEE SCHEDULE Permit is
CITY BLDG.. //%2.a00 Plan No
.ao CIT 0 • • PARK HEIGHTS Plan . /5 !I
.
STATE SURCHARGE 17, O (For Dept, use only)
BLDG. PERMIT /.1". S?)
CITY UTILITY S
EXTERNAL
METRO S.A.C. PLBG. y4 APPLICATION FOR PERMIT
UTILITY CONNECTION ?tin ,/.70
Date 6 43 19
TOTAL AMOUNT DUE 9 0 )
STRUCTURE USED AS
REFRG
HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES X ES X 1 1 _ 1- 1 —_ ____
l 1 l I l 1 1 1 U C
Owner >./' .. a-Q. Address
Architect Address
General Contractor Address
Con ctor Reg. No.
, /are :
NUMBER STREET SIDE
BETWEEN WHAT CROSS STREETS
$ A2 S • I-,
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
I
WIDTH LENGTH HEIGHT NO OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
BASEMENT O YES DETAILS OR REMARKS:
O 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 City of Oak Park Heights. Contractors must register with the village before permit can be issued.
OWNER /CONTRACTOR SIGNED
OK'D BY