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Gty
Contractor
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Perm~ No.
Prior Lake, MN 55372
TYPE OF STRUCTURI;
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Single Family .
Commercial
. Two-Family
Industrial
Multi-Family
Other
Public
Date
Fee Schedule
Industrial, C.." " . ,,;al & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fineplace
R..,,'~. :.11, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
( $39.5?
Heating Contractor
~;; -- ;; .. ~ Jr to add the State Sure; 1':"':1';' ....., '1te--bt.uu, I I u: U,i6 apl .;....Q.~;u".
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Cond~ioning. ~ 5\)~ '-3() ~ouse Heating Test Record must be s b 't1 d' ..
.' . urn, e w,thbu,ld .
~".=-,_,. ~ ~ ::.....2. .5 'ng certificate of occupancy will be issued. .ng MUn!l ~ before build-
HEAllNGOR~ Ion 'AktlfATrw
Steam
Hot Water 01
Radiation. . 10/03/20 DE 1'0
Special Devices CLOSED D
- n-t<\C1l'llT'i
Other Devices
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
Conn. Load
Fuel ['IrA. aaSFlue Size <-P U C
Supply Ope~ .
Return Openings .
InputSQ.~put J~ ,l$X:)
'IS. ,REOUIRED w~h number of supply and return openings listed per
opening. New structures or additions send floor plan w~h supply
hown. HEAT LOSS CALCULATIONS, PAYMENT AND
'3E MAILED TO THE CITY OF PRIOR LAKE, t6200 EAGLE
JR LAKE, MN 55372.
__.s are 8 a.m. - 4:30 p.m.
Edr.
..LL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Clm.
447-4230
TYPE OF WORK
. Replacement Y New Construction
. Est. Comp. Date
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
"~~~~
Appllcan)yngn~tune ~
7' l, ,./, 4,
Bulldf7 Signature
Merations
7 -3 (- C:J::)
OD-Ob J':>
Repair
Est. Cost $ Building Perm~ ,
HEATING PERMIT FEE $ <-31. 5 n
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ .l..J D. CTO Receipt , 37 f:(' 9 C,
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, 'Date
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