HomeMy WebLinkAboutHeating Permit 11-0478 0 0 0 000000 "0 0 > E
$ o n o u) _ �"1711 0 z 0 q )
/> o 0 2 \ m § c E k§ m 70 m \k
R
h r � §� ) t %B \d 2 $§
%$ j q G ® 0 k 3 z q
f • � a ) � d � ., 2 "* % k z] ) mm
m o
/ 0 , z 7 , 0 Il k
to) ) § § 2
§ m �o o , ' { N /OE/ •
z m m m _ 5
k K } 73 �t e
0 ... § K m kK CO \ \ k
\\\ 1
§ 0
0
rmoo 73 74 E
% 2 z e > z r
2 } CO fr.. A pia • ��� g §
ti.
k q
Epp
/ 0 /
t-, § 0 • 200020 A ,
_ >II §2 7
• v § § -®
\ \ ��� \§
\ m - 73 r k
)> z
wr 0
4 r RIp CITY OF PRIOR LAKE Date Rec'd
� t, HEATING /AIR CONDITIONING/FIREPLACE PERMIT
X
U by
/A'NESD�P 21 , 4
3. GrPink File een City PERMIT NO! ,7
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
3°lf 5 4�rs'niro SkM -1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
M \ dui\ l 1 I p ; tel 9 _ S9
(Name) (Phone
(Address) 111'5 -Th 3 e-e`
APPLICANT v� �y
(Name) \ 'Oh J 11 1 J 11anl ea d (Phone) q l ' N ;l• gEjS
(Address) \'fib\\ D 1a l'!c Icy. 4am Qoad NtYkkoe- • It
(Address) (City) (Zip Code)
(Contact Person) l..\n1 (Phone)
[APPLICANT SIGNATURE ,Mkt. t. , ') u11A DATE U' O 1 I
APPLICAN PLEASY COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL {., tA, I CI) kA A- P rvw q a- -f FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
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
OAir Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
1 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
Restential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Inc iwuu,cau,a .LdLuica S J40'15.140 )St $ Building Permit # •
"SURCHARGE" has been changed for one
year effective [EATING PERMIT FEE $ R.�
July 1, 2010, until June 30, 2011.
The minimum surcharge for a 'fixed fee permit TATE SURCHARGE $ • O ao
is 'ti, beginning July 1, 2010 OTAL PERMIT FEE $ 5t• 5i
This Application Becomes Your Building Permit When Approved Paid _ Receipt . G Z 9-y:6
Date lP . ( 4„ , / / By
Buildine Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
_