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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Hate Rec'd
~. :';1;:,';." ~~~Cy fPEitMIT NO. 0 ().O 0. '" II
I, Yellow Applle"n! ~ U . f) '- .
~l- 4J---
l
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER.--JV1 ~11 ~'A.I. A ~A""" A
(Name) .", I~ __.__J'''-'V ~~
(Address) /137;;1. ~ ?""~..5 ~ \
13
..;;t;.-f}lA-
(Phone) ~~ ,,"~~cJ '-663[;
MA; 6'-($'37~
APPLICANT
(Name)
(Address)
HEATING & AIR CONDITIONING
AIR MASTERS/He
hone)
6915 - 146th Street West
Apple VaHey, MN 55124
(952) 431-5932
(City)
(Contact Person) _ tehone),______
APPLICANT SIGNATURE ~~~-<< DATE ~..;jpc:r
APPLICANT PLEASE COMPLE'tE UELOW
ONEW CONSTRUCfION /N'REPLACEMENT 0 ALTERA;nONS
FURNACE MAKE AND MODEL ~jJ - traR/90 G FUEL 72J ,--I;j~
FLUE SIZE ~ U RETURN OPENINGS INPUT 6~ (Jt')O OUTPUT 5.~60
(Zip Code)
TYPE OF SYSTEM
QaWmITI Air Plants
DOravily
o MechanicRI
DAir Conditioning
OVen!. Systetll
HEATING OR POWER PLANT
o Steam
o 1-101 Water
o Radiation
o Special Devices'
o Olher Devices
PLEASE NOTE: Air Conditioner
Unit.'i Hnd Fireplaces CHnnot Encroach
into Required Side Y nrd Set backs.
Fireplaces with Uox Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Mulli-Family
FEE SCHEDULE
1% of job cost Residential. Gas Fireplace
$49,50 minimum
$149.50
$64.50
.$49.50
Residential. Heating &A/C (New Conslmction)
Residential. Healing Only (New Constmcrion)
ResidclltinL Additions & Alterations
Residential, AC Only
$49.50
$49.50
Estimated Cost $ ~tJ 6(j .
Q<'
;:;---
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Apl'tovecl
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
-0
$~~q 6_
$ .50
$~.'-.~
~
I>Ate
Pai(~. CIV
Da~ d . " . oe.
0, ..sG 90S
IlllildinlZ Officinl
-- ---..
24 hour n!ltke Cllralllnspectlons (952) 447-9850. rllx (952) 447-4245
4646 I>lIkotll Street S.E.. Prior I.Rltp_ MI"""o,...~ 1:1:2"7"