HomeMy WebLinkAboutME 1975-833 New Single Family FEE SCHEDULE Permit No. R
VILLAGE BLDG. oS,q .5 VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE J` (For Dept. use only)
BLDG. PERMIT 3•4)v
VILLAGE UTILITY
EXTERNAL. PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION
Date (--) r 7 `7` 1 7�
i% n -7r '
TOTAL AMOUNT DUE //,' L(.-C
STRUCTURE USED AS
REFRG . HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES g I 1 1
1
BY X
Owner Address /S- �L .g 4 f
rchitect ` Address
Contractor . -_'«_.. —.� ,
. Address
Contractor Reg. No.
NUMBER STREET ,�/ SIDE BETWEEN WHAT CROSS STREETS
/� -,.3$ . ' .�V •
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: *6..je/',I72 —rz • ;
BASEMENT
0 NO . F
J 1111W44 �
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The undersigned hereby makes application for a permit to do Building Work as herein specified, agr /ing to do all work in st t accordance with
all ordinances of the Village of Oak Park Heights. Contractors must register with the village • - pei it can be i s.ed.
OWNER /CONTRACTOR SIGNED —4-4.......an..c...—.L.
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