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HomeMy WebLinkAboutBP 1975-864 Fire Damage Repair r FEE SCHEDULE Permit No. go- VILLAGE BLDG. I' _ VILLAGE OF OAK PARK HEIGHTS Plan No. STATE SURCHARGE , (For Dept. use only) BLDG. PERMIT a© VILLAGE UTILITY Q vCi /' METRO S C LBG / r APPLICATION FOR PERMIT k i ha l / 7 UTILITY CONNECTION / / / 4• Dat 19 /c TOTAL AMOUNT DUE STRUCTURE USED AS REFRG . HANG MARK BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN SQUARES ' (I ( BY X Owner 1 4 a-�� 5 I Al- - S-Liexak--C__A-1/J Architect Address General Contractor iii) Address Contractor Reg. No NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS �, /� AT LOT BLOCK ADDITION OR T7,•'CT WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE LOT WIDTH LENGTH HEIGHT NO. OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE STRUCTURE R■6oa _ ❑ YES DETAILS OR REMARKS: � BASEMENT +} ❑ N O (9...43 M fg n1,Q / -- The undersigned hereby makes application for a permit to do Building Work as herein specified, agree to do all work in strict accordance with S .Qui AkeS—, all ordinances of the Village of Oak Park Heights. Contractors must register with the village fore pe can be ' ued. � 1 WNER /CONTRACTOR SIGNED ( c5-O - to--- su OK'D BY