HomeMy WebLinkAboutPL 1980-1773 New Single Family Permit No.
FEE SCHEDULE l� Db CITY OF OAK PARK HEIGHTS Plan No.
CITY BLDG. i• 7) /' (For Dept. use only)
BLDG. PERMIT SURCHARGE / V;
CITY UTILITY
GY RNA . PLBG• APPLICATION FOR PERMIT
UTILITY CONNECTION
TOTAL AMOUNT DUE STRUCTURE USED AS
HANG
BUILD MB.
REFRG . ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK PLUMB. HEAT INSTALL � U
SQUA IJ(I -' - -
BY X RES` ��/� ��
Owner - ....s A`,,,f / Address
Address
A Ite t
� `r ' Address
Contractor
Contractor Reg. No.
NUMBER STREET
SIDE BETWEEN WHAT CROSS STREETS
ADDITION OR TRACT
LOT BLOCK
WIDTH DEPTH
SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH
HEIGHT NO. OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
DETAILS OR REMARKS: rr¢��si....,- --
Q YES
BASEMENT Q 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 ordi nances of the C ty of Oak Pak Heights. Contractors must
st register with the village befo a permit can be sssued
OWNER /CONTRACTOR SIGNED
OK'D BY _ —.14.-46., �t =` La