HomeMy WebLinkAboutMECHANICAL 06-0493
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~"w EJ~icant I PERMIT NO. 0(0-- 4 q .$
-5~~ 7 E)r~ ~. ::::K-__,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT ! BLOCK 3 ADDITION
OWNER W r0cl...~
(Name)
(Address) oLt-t-7 ffCC:jl.S G-,. ~E-
-0
'{::hI -..:r::.i...<"Y""\ I e:":~ e....-tL....y
(Phone) q 5;2-LJLIo-9 ~(Yl
PClor U-- fh/'J 55 j '7~
.
APPLICANT _ . '
(Name)t_0{)h le.r~) ~idL+J~. ~ QjCJ
(Address) It,q Sa Ui . i ~ Ln;h ..st- ..::tr: l Ci.c
(Address)
(Contact Person) 0l.Ll'1. 1 _
APPLICANT SIGNATURE 6" ~. cL le._Art u~
q ~-Lj3J- 7Diq
..5S ,-
(Zip Code)
(Phone) "2 -43 f-10QQ
DATE [;)- ~
(Phone)
Ale- DNEW CONSTRUCTION ~REPLACEMENT 0 AL TERA TIONS
,." Ijll \Cii: MAKE AND MODEL ~l""f""On::_ ~ IlL. -bfJ - -H ~A 3~-Y--A 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
~Mechanical o Radiation Cannot Encroach into
ir 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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ ~XJ-:-
.
Building Pennit #
Tlee llse Only)
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
39. ~-o
~o
YD.
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fa (952 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372