HomeMy WebLinkAboutME 1973-665 New Single Family FEE SCHEDULE Permit No. ___M�
VILLAGE BLDG. o2- VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE • n eo (For Dept. use only)
BLDG. PERMIT 3`
VILLAGE UTILITY
EXTERNAL, PLBG. . APPLICATION FOR PERMIT
METRO S.A.C. /��
UTILITY CONNECTION Date L 2 1 7
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TOTAL AMOUNT DUE Aei ,,,zte.e
STRUCTURE USED AS
REFRG. HANG
MARK BUILD PLUMB. EAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES U
BY X
Owner tek 1'J(i e->!% � Address / `��' Z � L` U` 44 J Q '
' rchitpc Address ,/
!" - •e" ontractor � ,'�JTI.2L iS f Address 4 1 7 (S�i � e 7Ze.
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
/4S freA/ Z _ezj dr
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
• WIDTH LENGTH HEIGHT NQ OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE 4 goo. ° 2--
X-15 DETAILS OR REMARKS: Z14--e-4 12 C'J3 _cS�Z
BASEMENT '"l ' l� - �
0 - i
Z3 — / / /
The undersigned hereby makes application for a permit to do Building Work as herein specified, agr 'ing to do all work in strict ac •rdance with
all ordinances of the Village of Oak Park Heights. Contractors must register with the village befor permit be issued.
OWNER /CONTRACTOR SIGNED - - - // • - 12 �- "
OK'D BY s /. - f ,�