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FURNACE MAKE AND MODEL \j\ t_ - ( C(...00 ( aM. Pt l FUEL Nckra ( UrdiS
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
❑Gr ity ❑ Hot Water into Required Side Yard Setbacks.
Mechanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. 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
The Minnesota Statutes § 326B.148 :ost $ 3er7. CO Building Permit #
"SURCHARGE" has been extended /'
until June 30, 2013, HEATING PERMIT FEE $ �1 q . 50
The minimum surcharge for a STATE SURCHARGE $ 5 , w _.44— L
"fixed fee" permit is $5.00 COTAL PERMIT FEE $ `c , -j.)
This Application Becomes Your Building Permit When Approved Paid 0 R ipt N M - 13 fp
Date (, t ,
Building Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372