HomeMy WebLinkAboutME 1982-2019 Swimming Pool Heater Gas Line FEE SCHEDULE i Permit No. c:249 �Y
_DG,. 3 a,e--0 CITY OF OAK PARK HEIGHTS Plan No.
URCHARGE 4i�° (For Dept. use only)
=ERMIT
- ILITY
A PLBG. APPLICATION FOR PERMIT
CONNECTION Date 19L
AMOUNT DUE 5
STRUCTURE USED AS
REFRG HANG
BUILD PLUMB. H2 INSTAL n `- ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
1 ' (''1 64)--'e / Address / 91 . - -=.4".
C . , a
= Address
Contractor Address
-or Reg. No. 0.--) -1L,. .�� 1/ 3 50 /r
'h,--_ S.ea V)---
STREET SIDE BETWEEN WHAT CROSS STREETS
....- Aifit.d 4—&-617.4"
BLOCK ADDITION OR TRACT
WIDTH 1 DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
WIDTH LENGTH HEIGHT NO OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
0 YES DETAILS OR REMARKS: 9 1 , ice
O NO A `, ! , /, / .� !t- f /CC -. , IL.,,,,,,,.......
Wined hereby makes application for a permit to do Building Work as herein specified, agreeing to do all ,Ark in strict accordance with
:es of the City of Oak Park Heights. Contractors must register with the village befo ermi an be issued.
OWNER /CONTRACTOR SIGNED (c:10
OK'D BY