HomeMy WebLinkAboutME 1973-672 New Single Family FEE SCHEDULE Permit No. - ( 0/ CV
VILLAGE BLDG. 646:75 VILLAGE OF OAK PARK HEIGHTS Plan No.
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STATE SURCHARGE ,n t,, � (For D P t. use only)
BLDG. PERMIT p( 4 ?ff
VILLAGE UTILITY
EXTERNAL, PLBG. APPLICATION FOR PERMIT
METRO S.A.C. j
UTILITY CONNECTION Date l// J ' 197
TOTAL AMOUNT DUE / _ ��e_e /
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
Z I( t U
BY X
Owner /6-'1-e'a" 7 Address /'i — 2 .)to s �0 :
chitect
/ Address
ontractor �. . -0 .. . . .. Address 67 9 — 40-4-4-'2.1 . 6
Contractor Reg. No. /�� L �Z -�Pii, Js`c,
NUMBER STREET 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 �E VALUE
STRUCTURE ya Q eo
BASEMENT ES i / DETAILS OR REMARKS: / � h �
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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