HomeMy WebLinkAboutPL 1980-1724 New Single Family /
FEE SCHEDULE `v / Permit No. /7-2 y
CITY BLDG. 33. c-t9 CIT` • 0 K PARK HEIGHTS Plan No.
STATE SURCHARGE /.S (For Dept. use only)
BLDG. PERMIT 3? ..s
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A -C-
UTILITY CONNECTION Date S � 7 19
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN ri SO BY X UARES L_/ /J I
I - I EPA
Owner JA- q U .. 111 Address (a(3 So 4I S i,
Architect Address
General Contractor a'" _ Address
Al;
Reg. No.
i
r
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
5 62__A411( e45-r
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
ZYES DETAILS OR REMARKS: /3
BASEMENT c �- --
0 NO
The undersigned hereby makes application for permit to do Building Work as herein
9 Y PP P g specified, agr-eing to do all work in strict accordance with
all ordinances of the City of Oak Park Heights. Contractors must register with the village before pe it it an be - ssued.
OWNER /CONTRACTOR SIGNET C. ,f. .
/
OK'D B