HomeMy WebLinkAboutPL 1973-595 New Single Family /'*•\
FEE SCHEDULE
Permit No.
VILLAGE BLDG. _I0 ( VILLAGE OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE . J V (For Dept. uae only)
BLDG. PERMIT /'v o p
VILLAGE UTILITY
EXTERNAL PLBG APPLICATION FOR PERMIT
4
METRO S.A.C.
UTILITY CONNECTION Date iL �- = 197
TOTAL AMOUNT DUE - -
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
BY X
Owner 0 J,42.-13-r---' Address i 4k' 9 - L 1 \ Lt • YL '
Architect Address D
IGeRerel Contractor ' CM C1
'1^ L't' • Address Q" t t aQ�. \2�.�...
Contractor Reg. No. �! A. Ate C . v �� ' i
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
I 1. t0 *1 DI- - Yl .
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
BASEMENT ❑ YES
DETAILS OR REMARKS: ;,,�j
❑ 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