HomeMy WebLinkAboutBuilding 05-0764
CITY OF PRIOR LAKE
HEAr- -- ~~~T~T"""'T"",uTl".u"'roIREPLACE PERMIT
THIS FILE HAS BEEN
CLOSED DUE TO
INACTIVITY 4/16/2008
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I ADDRESS
1/2> 1)aJJ, sf- S~
Date Rec'd
I. Pink
2. Green
3. Yellow
~~~. I PERMIT NO. ()'- - 710 r-f
Applicant ::::J
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT LOCK d-.umrTION
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~;;~~ANT C~ tyv~~l) ~
(Address) S-ff~ - I--Ie; t.- ,)-J- tJ Jl>-pl
(Address)
(Phone)
PID ''08-00Lj
~ V.J.. 7</J 5.>>1
~PLICANT SIGNATURE
(Phone) 9SJ. ~'31 SC}Sd.-
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(City) ()
(Phone) l-/2/-S9..3d...
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(Zip Code)
(Contact Person) ~O-!
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT 0' AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
~echanical o Radiation Cannot Encroach into
Air Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
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 & AlC (NI:W Construction)
Residential, Heating Only (New Construction)
$39.50
~
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
ST ATE SURCHARGE
TOTAL PERMIT FEE
$ 39.nJ
$ .50
$ J..;11) .-
lice Use Only)
Building Official
This Application Becomes Your Building Permit When Approved
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372