HomeMy WebLinkAboutHeating Permit 11-0841 OO - n 000000 7 0 a zg
.... / o 0 � � • C ) > TI E 11 11 11 5 8 -cg C O m m x � \
\ a x 7 7 7 r ■z om � CD m m ' m � �zoz
§ ■ \ § ®qo P �k
& x ; » @ n z 2 § 73 § 7 j n 0 a�
t 0 n Z � � I. > m A
§ § q
m 0 k k
z 0 0 000000
m m m m ■gym *c
\ q K v§ I o c - I o c
) 0 K i - | I �$ m 0 0
,-.1, k m § q a § §§ § _ 3 q
k ] \ k , � // z . c
0 • f /- -9� P m
12 / 73 - ®
c 0 , /� c. ∎
< �\ ¥ 1 000000 o
2 22$ §q• � 2 kx
R. v ® m E -0 §$
_ z
\ §
(1. � �kk��
` A g k
� 2 z
w7 0
V Rjo CITY OF PRIOR LAKE Date Rec'd
?,. HEATING /AIR CONDITIONING /FIREPLACE PERMIT ' 2 / 1
. t," ! 4,INNESo 'c¢ 1. Pink File
2 /
Green City / V
PERMIT NO // �
.
3. Yellow Applicant `
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
c�
70 0 ear r e. Lan / E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER /,,,, ,
(Name) /// a i' l , U S CL n Hein (Phone)
(Address) /1j/ 700 da r ' ; etc e L an e ., /v. e Pr Is o r 2 a.k? hi A) -56:3 7O2.,
APPLICA
(Name) (�J a &i. / :4 ti e Q=1 n q e 4 , k,se I� �J L c�S (Phone) ( ?) '90-3 - /I/ ?J
(Address) is g J. /' n41-t '7 g r ` c I A p tic .S X3 79
(Address) (City) (Zip Code)
(Contact Person) el .b , 4 e 2-0 c- (Phone) 9 •S� V'03 -' /// 0
APPLICANT SIGNATURE f)(9 -- 41(4-23—D DATE v S'cPD //
APPLICANT PLEASE COMPLETE BELOW
ENEW CONSTRUCTION [f- REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL cat ri e r FUEL /(X27 "Le__
FLUE SIZE � RETURN OPENINGS INPUT 8Q WO OUTPUT 7.5; OCo
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravit ❑ Hot Water into Required Side Yard Setbacks.
ElMsbanical ❑ Radiation
Tr Conditioning 0 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
1 ne lvltnnesota statutes stb7s. tots )St $ 6 l 9 6, o Building Permit #
"SURCHARGE" has been changed for one
year effective EATING PERMIT FEE $ 9 5 -
July 1, 2010, until June 30, 2011. 9
The minimum surcharge for a "fixed fee" permit TATE SURCHARGE $ X60
is SS, beginning J uly 1, 2010 DTAL PERMIT FEE $
S1.SD
This Application t • omes Your Building Permit When Approved Paid S� (
/
� Re pt No./ D ((
Q� /
1 , (,� 1, Date /
Building 1 7P.11 Date ( r. 2/1, h
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372