HomeMy WebLinkAboutOT 198x-2194 Re-Roof FEE SCHEDULE r� / / Permit No. �/9
�._5 O CITY OF • • PARK HEIGHTS Plan No.
__ 439 -4439 (For Dept. use only)
:LJRCHARGE 'l/
=ECK
LITY
- AL PLBG. a `/, APPLICATION FOR PERMIT
S.A.C.
CONNECTION Dateae---P /6 19i`
AMOUNT DUE STRUCTURE USED AS
REFRG HAN<
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
0 C D 0 0 0 ? E_ 0 E
/7-6-1„, , A e Address
a �; / Address
Contractor ._ ems( Address
--or Reg. No. //��
STREET SIDE BETWEEN WHAT CROSS STREETS
BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
WIDTH LENGTH HEIGHT NO OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
J '- c.2 .
❑ YES DETAILS OR REMARKS:
❑ NO
igned hereby makes application for a permit to do Building Work as herein specified, agreeing to do all work i strict accordance with
:es of the City of Oak Park Heights. Contractors must register with the village before permit be iss n
. OWNER /CONTRACTOR SIGNED Ci
OK'D BY _