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CITY OF PRIOR LAKE
HEAT THIS FILE HAS BEEN REPLACE PERMIT
CLOSED DUE TO
INACTIVITY 4/16/2008
Date Rec'd
I/.',O!)
I. Pink
2. Green
3. Yellow
~!~. I PERMIT NO. OS'. /11 ~ I
Apphcant
ZONING (office use)
15290 FAIRLAWN SHORES TRAIL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
SCOTT BREMER
15290 FAIRLAWN SHORES TRAIL
(Phone) 952-440-7632
APPLICANT
(Name) RON'S MECHANICAL, INC.
(Phone) 952-445-8585
(Address)
12010 OLD
SHAKOPEE
MN
(City)
55379
(Zip Code)
(Contact Person)
UPLICANT SIGNATURE
(Phone)
DATE
\ \-1-'0<;
.~
DNEW CONSTRUCTION ~REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL --Lo.n no x. Gl.QlmfJV-3/Clc.-01D FUEL _;1/0
FLUE SIZE RETURN OPENINGS INPUT qo ,000 OUTPUT €3 ::rOO
,
TYPE OF SYSTEM REA TING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
~Vity o Hot Water Air Conditioner Units
echanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
APPLICANT PLEASE COMPLETE BELOW
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit # 0 S, / I / Z
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3=\, g)
$ .50
$~.()O
.tice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 10 I UV
Date / t(; 0 \'
f. ,
Receipt No. 5lJ373
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372