HomeMy WebLinkAboutME 1973-613 New Single Family n
FEE SCHEDULE Permit No. Ce1/ 3
VILLAGE BLDG. _3ZIS VILLAGE OF OAK PARK HEIGHTS Plan No.
` S� '
(For Dept. use only)
STATE SURCHARGE /
BLDG. PERMIT A� `/�,
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. 19 'f
UTILITY CONNECTION Date L e./ /2-- 19
TOTAL AMOUNT DUE /-41/4.-z. ^ CC.
STRUCTURE USED AS
REFRG. HANG
MARK BUILD PLUMB. H INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
BY X __ _,_/
Owner teen 7�`e - � ' c— te-c /-C1 Address ��'�'�`5 � .5 L �r
A chitect �� Address
ontractor !Alt - ..- - - -,
' it_ • . Address (9/ �� La, X. /
Contractor Reg. No. t2P.e-
NUMBER STR ET 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 ti. YES �� DETAILS OR REMARK � C� _���,a� t /`�
BASEMENT / S o - o /_ 1 / i�
NO l 1 ;7 /P3 — P . n /1 Prl.?��c.o . ..4-61,2.1....-A '"' J / D 0 e e
4t 24' ,..e... t
The undersigned hereby makes application for a permit to do Building Wor a s specified, agreeing /. do..II work in strict accorda c with
all ordinances of the Village of Oak Park Heights. Contractors must register with the village before per can`/ issued.
OWNER /CONTRACTOR SIGNED
t•/ J • e.
OK'D BY 44 = Zi ar
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