HomeMy WebLinkAboutPL 1979-1503 New Single Family FEE SCHEDULE Permit No. 1.5
CITY BLDG. /7. CITY OF OAK PARK HEIGHTS Plan No.
STATE SURCHARGE � n 't (For Dept, use only)
BLDG. PERMIT /7
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. /�)I
UTILITY CONNECTION Q( '/ // O �yc�
/N J(� / // / J ! G Date /� 19 LL
TOTAL AMOUNT DUE Q .r /i _ /
TRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB . HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
S Q U A R E S ,
- n ^_ U I C C
ay x I�A�
' �� �,
Owner tl% 6 Address �� �
/
Architect Address
GerreratContractor _14. .l.r�-ecs. A: �„ . Address ::;;/„ 1.,.ir U�
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
5 7 V . .
LOT ();LOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE
1 FRONT BUILDING LI•,
LOT
WIDTH LENGTH HEIGHT NQ OF STORIES TYPE OF CONSTRUCTION ESTIMATI
STRUCTURE
BASEMENT
0 YES DETAILS OR REMARKS: t
Cj 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 City of Oak Park Heights. Contractors must register with the village before p jnit caa be "sued.
OWNER 'CONTRACTOR SIGNED L%r!ril
7
OK'D BY / //?