HomeMy WebLinkAboutPL 1973-597 New Single Family Permit No. ,;:—..--q7 FEE SCHEDULE
VILLAGE BLDG. y06 VILLAGE OF OAK PARK HEIGHTS Plan No.
(For Dept. use only)
STATE SURCHARGE FS-0
BLDG. PERMIT G O AZ
VILLAGE UTILITY
EXTERNA4 PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION Date 17
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG. HANG
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
MARK �}( I I
SQUARES IJ
BY X I` •
Owner A ! '
A. �II i _ , Address /
Architect Address /''
' Address Id 'General Contractor �%� — �/- " - —' '
Contractor Reg. No.
1
NUMBER C t STREET SIDE BETWEEN WHAT CROSS STREETS
/'Ss5 c 4,e >44-
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:
0 BASEMENT 0 NO
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