HomeMy WebLinkAboutPL 1977-1165 New Single Family FEE SCHEDULE Permit No.: I ( L
VILLAGE BLDG. ��.o0 VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE r (For Dept. use only)
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BLDG. PERMIT • J v
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION Date a
ppp 19 �
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK \
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES I ! 1
BY X
Owner Address
Architect Address
General Contractor I _ S t l I . , • Address 97 (LI 14.4.-tg
qv
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
(zsA) 657 44 n.
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT NO. OFSTORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
BASEMENT 0 YES DETAILS OR REMARKS A'S
O N O . g jl(rrt0
gS; 6
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
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