HomeMy WebLinkAboutPL 1971-336 Connection to Municipal System c
� — p Permit No
$ 7-S ~0 (Building) ILLAGE OF OAK PARK HEIGHTS Plan No.
(For D
TOTAL FEE COLLECTED
DOUBLE FEE COLLECTED
ACCOUNT ORDINANCE �f /
VIOLA TION / /� `
(MARK X IN SQUARE)
APPLICATION FOR PERMIT
Date (
J
• ,`
T0: STRUC-
REFRG.
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE
SQUARES LJ
BY X ^ t
Owner '"--. 24.17 7?L z; A/ Address l/r-ca
Architect Address
General Contractor Address
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BU'.
LOT
WIDTH LENGTH HEIGHT NQ OF STORIES TYPE OF CONSTRUCTION ES
STRUCTURE
0 YES DETAILS OR REMARKS: a
BASEMENT 0 NO a2 - &
itcy_t„,____ 6.44,4e
The undersigned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work in str
all ordinances of the Village of Oak Park Heights. Contractors must register with the village before permit can be issued.
SIGNED
BY
•