HomeMy WebLinkAboutHEATING 07-0050
CITY OF PRIOR LAKE
HEATJNG/AIl,~~O-~ TIONING/FIREPLACE PERMIT
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Date Rec'd
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Applicant
I PERMIT NO. () 7 () () 5 ()
ADDRESS D
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
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(Phone)
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1:;~~ANT r:;;"", wk ~ff1 '&-1/0 M {J (phon,) o/Ftf- (};f!-~33-- Ir}t!:<
(Address) (J7()() FalYII t'eV IfOfL. ' R(}seo ,'\{,4 ) J1UV \ _Li57[?
(Address) (City) (Zip Code)
(Contact Person) rJ d Vrtf eJi. tJ - . . (Phone) ~ ~ ~ 33 -//J 1/.,1,
APPLICANTSIGNA~ ..fd/l~~~ ^ DATE '1/,19 I (J)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Address)
TYPE OF SYSTEM
HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
DWarm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
DGravlty 0 Hot Water
. 0 Radl'atl'on into Required Side Yard Setbacks.
o Mechanical
DA' C d't' . 0 S . I D . Fireplaces with Box Additions or
Ir on I lOlling pecta eVlces '" .
DVent. System 0 Other Devices Cantilevers to the Outside of BUlldmgs
. /J Require a Building Permit.
FIREPLACE MAKE AND MODELH&l- n;.r.Jo pAatl4/: (,rJI}o a; .'1 --:J fl.:1--jc s y::.'f ~ ~
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace $39.50
$39.50 minimum
Residential, Heating & AIC (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $39.50
Estimated Cost $ (J.. (!) rJC) .-
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
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.50
4(;. (/1/
'0ffice Use Only)
his Application Becomes Your Building Permit When Approved
Buildinl! Official
Date
Paid
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Date ,
I. .Yl ~'7
Receipt No.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
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