HomeMy WebLinkAboutPL 1987-2459 Water & Sdwer Connection FEE SCHEDULE Permit No. 5/5 7
CITY OF OAK PARK HEIGHTS Plan No.
CITY BLDG. 439 -4439 (For Dept. use only)
STATE SURCHARGE
PLAN CHECK
CITY UTILITY l // 7. e" --73
EXTERNAL : Q'71 APPLICATION FOR PERMIT
METRO S.A.C. / 737 d----(J
UTILITY CONNECTION . 5 e' . cfr- e Date y� j • 19
�I "" �}- z ¢' u•d-a-(-
TOTAL AMOUNT DUE U i/ Q' . gee
STRUCTURE USED AS
REFRG HAN(
MARK BUILD PLUMB. HEAT INSTALL -^ ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES I l ^JI ^I U E
BY X -
-
Owner 4, "7` . E Addres — . 1 __..e �� _ _ _ _
Architect ,, / /// Address
General Contractor ,i_ � . / Address
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 NO OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
❑ YES a. gy� DETAILS OR REMARKS:
BASEMENT aJv� '/ J
❑ NO }VO 4
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 can be is d
OWNER /CONTRACTOR SIGN , ,�.
OK'D BY