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JAtl-28-2008 08: 18 From:HILPIPRE HEATIt~G+AIR 507 334 2899
To: 9524474245
P.l/l
CITY OF PRIOR LAKE
ilEA TING/AlR CONDITIONING/FlRRPLACEP:ERMIT
Date Rec t d
ADDRESS
llod-\~ FrOvf\k-lir'\
/j2 ~~ 8
i. r:.:.. ~;y I PERM.ITNO'OE - 003 c:'"'
) y.u.... APfA'(IIIIl :::J
() St;3" a I ZONING (ol1i<:e,*l[
l-i'fc1e... "'PYioy l~f({.1 ~ .
LEGAL DESCRTP110N (ollicf UIIll only)
LOT
BLOCK
ADDITION
PID
OWNER J
(Name) 0 h n
(Address) I (tI ;;11
(Phone) q5~-Y~"1oY
La.. IoU.. fv\.,n 553"1
APPLICANT Ui'l()iaf1 \\J'l I\.~ '. "1 ~ 3"2/-) Cf t?
(N......,) '-'-'-':F'f ve ~ 1 ~ ~_ tt C. U C- (Phon,) "0>0,- 0 - 0. J n
(Address) I,/50 Ac.Drn y-~\ l FIlA-I b~)+ mVl 55D~I_
(AddrCIIU) (Cily) CZlp Cock)
(Conl3C[ Person) J.l rn lliJp.Lp Y' e~ (phone) 601- ::1 :3 L/ - OCl I ~
APPLICANT SIGNA TIJRE
DATE
DNUW CONSTRUCTION !&1REPLACEMENT D AI.TERA'f10NS
FURNACE MAKE AND MODEl.. .N'i""J: ty1 ,q:"R.1 y:. FUEL I'!,(yr.
3" P.J l 'NPu'ra5vf5'O ""IJ}.J OUWI.rr .J3-139 ~ ~
FLUE SIZE RI~TURN OPENINGS
1YPE OF SYSTEM IlEA TINO OR POWER. PLANT
~'WIlTll\ Air PIWltll o Staam PLEASE NOTE: Air Cundltloner
UnU. andFlrClpluce. Cannot Encrouch
Omvity ~ HOI WOlcr Into Requlrod Sldo Yord Selback..
o MechAnical Radialion Fireplace. with Box Addition. or
gAir Condilioni.\8 o Spociul Devico,_
Vcnl. Syp\cm o OIlier Ilavital Cantilever. to tho Out.lde or BulhJlolP
Require 0 Building Permit.
FI:REPLACE MAKE AND MODHL
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Indwnrio.l. Commcrcil1l It Multi-Family 1% or job 0081 Rooidonlil1l. Gos Fin:lplllOO
S39.S0 minimum
Residential. Hooting It Ale (New COJllltrucrion) ~99.S0 Rcsidonlinl. Addilions 8r. Alteration.
RORidontiol. HootinB Only (Now Ct.lOlTnlCtit\n) $64.S0 Rcllidenlinl. AC Only
$39..50
S31).SO
$39. SO
EsLimUlcd COBl S
Building Permit II
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 49.5""0
$ .so
S _~ .tJo
(Omr. u... Only)
n~:::to~.lIdl"~;&;"'PPro'od
llulldlnll OI11.illl ~ bo.o .
Receipt No. 5S I S' .:5
13y
24 hltUr nodc.e for all lnapedJmo (9!2) 447.98!O._CIB)'4C"'~;
4646 Dekota 8tnlll' S. E.. Prior I.u!!. MlnnesofA 5!J72