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HomeMy WebLinkAboutHeating Permit 07-1116 01/29/02 Tl~ 11:18 FAX 6124474245 CITY OF PRIOR LAKE 14J 001 HEATINGI CJ.J. i OF PRIOR LAKE :;/.udPLACE PEDlll "' . , \ Date Rec:'d ~ '1 F~"3 0 3 '[GG9 , '-J (flease~or1lriDtmd.sipubcmDml w.. seD. AuvAESS 5lSl Dl VYl~(A/1/lckV2;\ ~=.. S-lrluu.~A :NO. 07- ill'Co Sl- S~'. ZONING (oftiCe ute) LEGAL DESCR.u uON (oIIice ute o.aly) LOT BLOCK AuJJJ. HuN pm .~= ~\,tV\\/\~ \J~Yr~ ~~~) 4~D.Z(iJ2 (Address) c:::3:5'~ (/VDSS(A 1/\([ V(,~ ~+v ~~. (PL) ~-7Z- =~(4i!g;) 171:.~/?h~rj/7~t(p;Jrs~qi'l~ ( ) (City) , (Zip COde) (Contactperson) SL \~~1/\ .9 \) II F\.', \~ (Phone) :P x+ ?/~~ APPLICANT SlGNATURB ~I \L ll1L{. Y i I J~ J\ Q.../ DATB ,___,_..~ G L,o { APPLICANT PLEASE COMPLETE BELOW (]NEWCONS'mUCTlON U Ilt.PLACEMENT ~TlONS FURNACE MAKE AND MODEL FUEL FUJE~ \.;)\ RE1URN OPENINGS INPt1T . OUTPUT ---1 i.~ ;:pin. OF S\ ;)lA)M HEATING OR POWEll PLANT t~ \~fJ. :tyAirPlanU B~;w- ~~~~~Ilits \ ~ ~ MechaDical. 0 RldiBtiOD ,C8mlot Bncroich into (:f' Ii r Condilionios B Speda1 J)eyjces ReqUind Side Yard f Vent. Syst.em Odler Devices Setbadts -,., , -"'- "r_ . .._ "'~ ---.. Indllstrial, Commercial" Mula-Family Residential. Heating" Ale (New Cot\ltn1aion) Residential, Healing Only (New Construction) Estimated Cost $ FIE k,zu.DULE 1% of job cost Residerltial, Gas Fircp1lA:e 539.50 minimum -- -- - .,.', S99.50 Residential, Additions" Alb!l'ltions S64.SO , Residential. AC Only . $39.50 $39.50 $39.50 \. HEATING PERMIT FEE STATE SURCHARGE TOTAL ~~.MIT ,lI.. Building Pennil #_ $ ~0f.c::;D $ J .50 S LfQVO IhIlIdiIII ot&cial Daft . Paid 4-{). (/() Date ., t L { <0 - uf : "..-. , '.",~ h . aerY"NO. 65lJ3 Y I P '/ , (OIDce V.. 0DIy) I Thts Application Becomes Your BUOd"1 Permit WIleD Approved 14 hour notice for sll iupectioftl <'51) 447-9150. t.x (952) 447-4245 6