HomeMy WebLinkAboutBP 1976-1073 Remodel - Entry Permit No. l6� ll.J
VILLAGE
•
FEE SCHEDULE Plan No.
- VILLAGE OF OAK PARK HEI GHTS (For Dept. use only)
BLDG .
STATE SURCHARGE ' t � �\
BLDG. PERMIT
VILLAGE UTILITY
px7FRNAL PLBG. APPLICATION FOR PERMIT ` RIC
METRO S.A.C. Date `
UTILITY CONNECTION ` =- _ ♦"-
TOTAL AMOUNT DUE STRU USED AS
HANG
REFRG ALT R REPAIR REROOF RESIDE MOVE WRECK ri
BUILD PLUMB. HEAT INST� a —^ El MARK ^ —'
SQUARES
BY X
0.9\Q./j0-.0) Address `� `� �� ��-
Owner `""�
Address
Architect 9
Address
General Contractor - _ —
Contractor Reg. No.
NUMBER STREET
SIDE BETWEEN WHAT CROSS STREETS
/ / 7 J7c- ADDITION OR TRACT
LOT BLOCK
f MEI
WIDTH DEPTH
SIDE LOT CLEARANCE FRONT BUILDING LINE
ss
IIIIIIM
VALUE
WIDTH LENGTH HEIGHT NO. OFSTORIES TYPE OF CONSTRUCTION
STRUCTURE IIIIIIMINIIIIII .0
DETAILS OR REMARKS: 11[L1_,7,, I
.. ►+rJ
❑ YES
BASEMENT ❑ NO
The undersigned hereby makes application for a permi t ot dos Buliding register with herein vspece1ed, • aerpein' t adobaall work
ord in rict accordance with
T
all ordinances of the Village of Oak Park Heights. COWNER SIGN Ai.
0 K'D BY