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HomeMy WebLinkAboutHEATING 06-0438 (Please type or tlrint and sUtn at ADDRESS 170&.> ~;L\.h~-t_ Lr~L " CITY OF PRIOR LAKE HEft TTNGI AIR CONDIllONlNGI ~lKEPLACE PERMIT FILE CLOSED DUE TO INACTIVITY Sent Letter JULY 10, 2008 Date Rec'd L Pink File 2, Green CiIy 3, Yellow ApplicaM PERMIT NOo/)6 -L/3g ZONING (office use) LEGAL DESCR.1t' lION (office use only) LOT ~OCK ~ ADDITION b~-f-~ &:R { \m ("~\sh .J Df<.l-, ~\'Se.~t:::- 'L_~'-- L/ . . ~~;;:e~ANTlll-ftt ~,t2/1Jdi7{!. (phone) 9JZ-Mn-;57"7OJ (Address) J'1ztu() !iAt{)h!oIAJr/ Pel lAJifJ!c~h 6"5:372- (Address) · (City) " (Zip Code) (Contact Person) r<i.. ~ I (] ~ 'h G hone) ~ --.~.. 5L -Z"?J- APPLICANT SIGNATURE A DATE ~ - ' , ,. ' APPLICANT PLEASE COMPLETE BELO)V W CONSTRUCTION 0 REPLACEMENT ~ AL TERA TIONS EL FUEL TURN OPENINGS INPUT OUTPUT STEM REA TING OR POWER PLANT (Address) PID~Y /-3'-/ -!XJ 1-~ (Pho~(~-Lj:q74 S,C ,t-;)..,~ )%~lf'? o Steam o Hot Water o Radiation o Special Devices o Other Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FEE SCHEDULE I % of job cost Residential, Gas Fireplace $39.50 minimum Residential, Heating & AlC (New Construction) $99.50 Residential, Heating Only (New Construction) $64.50 Estimated Cost $ ~~c:C> $39.50 Residential, Additions & Alterations Residential, AC Only $39.50 $39.50 REA TING PERMIT FEE STATE SURCHARGE TOTAL PERMIT J:1EE Building Permit #, ~,g) ~' n ,VO .50 . $ $ $ (Office Use Only) This Application Becomes Your Building Permit When Approved Building Official Date Paid 40 -- Dat~. db" b Receipt No. ~/!./'7U ~ /~ ".. 1._.._ __.:__ ,__ ^11 :_~_^^.:^_~ (OC'" AA''-Ollcn tov (o.c;?) <L1'7.4?.<1.c;