HomeMy WebLinkAboutPL 1979-1504 New Single Family FEE SCHEDULE
Permit No. AS_G
CITY BLDG.. __ .o 0 CITY OF OAK PARK HEIGHTS Plan No.
.-C) (For Dept. use only)
STATE SURCHARGE , 7
BLDG. PERMIT _23_19
CITY UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. �y
UTILITY CONNECTION I7 Date /4 19L
TOTAL AMOUNT DUE 6 �7 �2_J� r � J�.r�_�Q�
�1 STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE ( MOVE WRECK SIGN
I
SQUARES 1 VI I , I I I I I 1 I D
BY X I/V t
Owner uF��.. vb a o) Address S 1d [ !i ,Csc.
Architect ,{ Address
GaPered Contractor .,„ 4 • •&'*-• Address / .r / ...14 41-.4
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT Na OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
0 YES DETAILS OR REMARKS! D
BASEMENT / / =L
Q N0 -f,( ltJ �f
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 per it c n 'sued.
/✓
OWNER /CONTRACTOR SIGNED
OK'DBY (.Y