HomeMy WebLinkAboutPL 1979-1663 New Single Family FEE SCHEDULE Permit No. ,
CITY BLDG. /7,60 CITY OF OAK PARK HEIGHTS Pion No.
STATE SURCHARGE ISO 7 '� (For Dept. use only)
BLDG. PERMIT X7, : )
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION 0 , /�
/4 /! ✓i a
/'6 ,p /(�C� Date � � 4 1P.1.
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR PAR REROOF R �E MOVE WRECK SICrN
SQUARES I I 7 U
BY X
-
Owner Address
Architect Address
General Contractor .Gr. Address -s 8" 7 t C *��J�h € --o-+
ontracto 6ieer -44e. .
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
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
❑ YES DETAILS OR REMARKS: i�'c
❑ NO
The undersigned hereby makes application for a permit to do Building Work as herein specified, . ing to do all work in strict acc2rdanc- with
all ordinances of the City of Oak Park Heights. Contractors must register with the village befor1. it can •e issue.
IIIIIM
OWNER 'CONTRACTOR SIGNED ' '. r1 - j
OK'D BY _