HomeMy WebLinkAboutPL 1977-1146 New Single Family FEE SCHEDULE Permit No. ( l `F'1
VILLAGE BLDG. dC VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE r (For Dept. use only)
BLDG. PERMIT. '47)
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. ( - -
UTILITY CONNECTION ( ���
D e
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG
MA RK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK H'O`NG
SQUARES I I 1 1 1 1 1 SIGN
1
BY X
Owner
It
N r\rl '\\( \ ....-\ I Address 1 LW S S 141St h.
Architect
Address
General Contractor t' —111 1`} IZ .eP 19C C VX c- Address r76,_' (-6-4 F_ r■ 1-,1 c, Rc!
Contractor Reg. No.
NUMBER STRE T 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
❑ YES DETAILS OR REMARKS: ' ,
BASEMENT •3 4' —j../ r �i .. , tf 1' / /i
❑ NO I
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 Village of Oak Park Heights. Contractors must register with the village before permit can be issued.
OWNER /CONTRACTOR SIGNED
OK'D BY '