HomeMy WebLinkAboutHeating Permit 11-0526 - 0 0 000000 - 0 o > k-n
� I * c:,
A n \ \§ R 0
MD c C 0 m§ m § o
/ 2 m m§ m z r �§27 § $ § -o
a ® � ° z k
% t ® m z o z
40 �� > z o • \ k z§ . _ z m m
\ k - z _- [
1 \ § 7 � ND
§ z x 0 0 ■ r EOCeo t
q M m m f�fltmr
r
2 - 3 ° ° im o e
o �� . ƒ7772 2 0
) § - F m
% m §
0 > 0 E w m
=1 § 6 z . 'MP �r - n oo z g 4 0
0 § m ^ \► / /\j P m
\ k 0
= m
/ o . 1
m 2 000000
} } m k§§)§ \
§ > �� ;�>
q aggzK
'I § m ® r -
« ) z - ) I1
w 0
kl (' CITY OF PRIOR LAKE Date Rec'd
� V Rip
,� HEATING /AIR CONDITIONING /FIREPLACE PERMIT
-
iit O 4` I. Pink File /'
j nNESV 2. Green City PERMIT NO. /�
3. Yellow Applicant `/ £ 7 /l /p
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
...- "3 ( / ' (-e_..1 gL\
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER 'n mil, U ''lD• 1 �
(Name) , 1 ... .:1_ d UL (Phone) W S 3
(Address) , Sp ; Q . . T r s ,il l6( L c U Z e j MA 5 )
APPLICANT eI l l ` �3 '91f � . 1 000
(Name) l � * t°) .� � (Phone) "b
(Address) t 'l 0 blAir@M
4C� /�" `�r `-' %3
D tt (A nn ddress i j (City) (Zip Code))
bite. (Contact Person) itq�tt l d (Phone) - 1a , c� I' Co V
APPLICANT SIGNATU • i.1 *Mil 1 ! . _', . 11 DATE V X.I
APPLICANT PLEASE COMPLETE BELOW
ANEW CONSTRUCTION REPLACEMENT El ALTERATIONS 04 FURNACE MAKE AND MODEL IS, i t ul� BU g OF 69 (' FUEL r,,
FLUE SIZE RETURN OPENINGS INPUT 1t� OUTPUT f� ,bt6D
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑ Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
DVent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
- 'ost $ L I I }. -- Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been changed for one
year effective IEATING PERMIT FEE $ sv
July 1, 2010, until June 30, 2011. ;TATE SURCHARGE $
The minimum surcharge fora "fixed fee" permit
'OTAL PERMIT FEE $ Sea
is $5, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid 9 1 co Receipt No. Sl
_I 0
Date1 +` By/
Buildine Official Date 1D 7/ ; ! ..
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372