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Heating Permit 11-0021
DATE TIME CITY OF PRIOR LAKE �� � INSPECTION NOTICE SCHEDUIED ,3 I 31 / 1 -r�-- ADDRESS S { l�� ��� �}�_ OWNER CONTR. PHONE NO. PERMIT NO. �l � (� � ❑ FOOTING ❑ PLUMBING RI ❑ EX/GRADIFILLING ❑ FOUNDATION ❑ MECH W ❑ COMPLAINT ❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI ❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE F1NAL ❑ FINAL 0 PLUMBING FINAL ❑ GASLINE AIR TST ❑ SITE INSPECTION �( INECH FINAL ❑ / � COMMENTS: �'��� � � � , � /7C.. m�,u. at�.o�1 <<w x(���k_�_� �1 ca�1 i(r✓t �WORK SATISFACTORY, PROCEED � ❑ CORRECT ACTION AND PROCEED ❑ CORRE RK, CALL FOR REINSPECTiON BEFORE COVERING Inspector: OwnedContr. CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH �c SAFBTY! ursNOr� i 4 P xr CITY OF PRIOR LAKE 1�ate xec'd - ° ����� '�-�� HEATING/AIR CONDITIONING/FIREPLACE PERMIT .� ���� .,����� 1. �a - �/ �, �.�. �f � � V ^$ � � �- - � >- ���'NES��f�' 1. f'�nk F;�� pERMIT NO. // O O Z/ 2. t3rern Gity j 1. Yellow ApplicaM f eese or ' t and si at bottom ADDRESS �� .� ZONING (o� �e) � � . LEGrAL DESCRIPTI4N {at�E'ice use oniy) LOT BLOCK AUDITION PID OWNER � : (Name) 1 a, � (Phone3 ��"� ���7 �„ ; (�aa�> `7 � ��'-.E� C� � � � APPLI ' ���—��ID� ,�j (Name) (Phone) � � Ip � (Address I / N ( dartss) (Ci (Zi Code) (Concact Pesson) (Phone) d � � APPLICANT SIGNA DATE � � � , APPLICANT P ASE COMPLETE BELOW []NEW CONSTR.UCT ON LACEMENT ❑ ALTERATIC)NS � FN 7"�-�a,�o�p y � FURNACE MAKE AND MODE Ua v �(� � FUEL ,�/���1}-� FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT , �arm Air Plants � S� pLEASE NOTE: Afr Conditioner pGraviry ❑ Hot Water Units And Flreplaca Cannat Encroac� ❑ Mecl�anical ❑ Radiation into Required 5ide Yard Setb�cka. ,�]Air Canditioning ❑ Spccial Devices '�P�� ��b �z Additjo�ls or �y�, g � p� �,;� Ceniilevers to t6e Ontsidc of Buildiegs Reqaire a Building Permit. FIREPLACE MAKE AND MQDEL FEE SCHEDULE Industrial, Commercial & Muld-Family 1% of job cost Residential. Gas Fireplace 544.50 ' 549.50 minimwn Residential, FIe�ting & 11CC Mew ('-�++atn�ction) 5149.50 Resis�itial Additio� � Altaetio�s 9.39` Resideatial, Heating Oniy (New Construction) 564.50 Residential, AC Only 549.30 Estimated Cost $ �(Qd� � Building Permit # The MinnesotA 5tntutes � 326f3.1�8 HEATING PERMIT FEE $ .�.�9,� �SURCNARGR" hus been ek�an�Cecl I'nr Une yeAr effCCtive STATE SURCHARGE $ dS�! Jut� i, ZlylO, unNt,Juqc 3�(►, 2U1 t. TOTAL PERMIT FEE $ , The minimWm surcA�ryte for A"fixecl Pse" permit (O� �� �,) kc,f,,,{. bc�iania� Jaly 1.2Q1U This Application Becomes Your BuiWiag Permit When Approved Paid ���� R' t o. /,� � CQ Baildiae Ofticiai Dah DatC/ //,' � / $ , V ( Z4 honr notice for Atl inspectioas (952) 4�7-9850, fax (952) 447-4Z45 4646 Dakota Stre+et S.E., Prior Lalue, iV�innesota SS372