HomeMy WebLinkAboutPL 1979-1605 New Single Family FEE SCHEDULE No. /t O S
CITY BLDG. CITY OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE S�9 �/� (For Dept. use only)
BLDG. PERMIT `�6/
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. {� ,/I
UTILITY CONNECTION 14 / y J� 7 __ c
( (/ �Y I /V) Date 19
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG
HANG
MARK BUILD PLU B. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQ n I I (1 l II 11 II n II n
Owner 1 ,4 9 w/A0 Address 1 Vk 57 - t ST. /r) -
Architect Address
.9 fr¢rs€roI Contractor G'�r tv4 '+�?'t7 g - 'Address
C ntractor Reg. No.
/X: 1* ----- ' f - 33.x/
NUMBER STREET SIDE BETNEEN WHAT CROSS STREETS
l y D 3Z ' S r . N , I J £ ! ' $ 9 , P sz ! S 2 - ei it e,.„
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT 1 NO. OF STORI ES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
//
BASEMENT O YES DETAILS OR REMARKS: �,�1/'���
❑ NO �/
The undersigned hereby makes application for a permit to do Building Work as herein specified -g eeing to do all work in strict accordance with
all ordinances of the City of Oak Park Heights. Contractors must register with the village bef• e p re it can be issu r.. e f X
OWNER'CONTRACTOR SIGNED • Arf
OK'D Bl