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O � pRlp� CITY OF PRIOR LAKE Date Rec'd
� 9 HEATING/AIR CONDITIONING/FIREPLACE PERMIT
� �
�j�'NES��A 1. Pink Fi�e
2. Green City PERMIT NO . '
3. Yellow Applican[ �
Please or 'nt and si n at bottom
ADDRESS ZONING (ofl�ce use)
��_ � rc� ���c� �� c�r JF
LEGAL DESCRIPTION (of�ice use only)
LOT BLOCK ADDITION PID
(Na�me) ��'{' � � � ��J N � � (Phone�� L� � C/ � �
(Address) L ���"I lt,-/41 � `4'V�l��.�(,/1 �r J� �� 11/��
APPLICANT
(Name) Rons Mechanical Inc (Phone) 952-445-8585
(Address) 12010 Old Brick Yard Road Shakopee MN 55379
(Address) (City) (Zip Code)
(Contact Person) L i nda (Phone) 9 5 2— 4 4 5— 8 5 8 5
APPLICANT SIGNATURE ► �C1el. Y��I'10'�� DATE �"�L�' �
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL 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.
echanical ❑ Radiation
1 Fireplaces with Bog Additions or
Air Conditioning � la � ��„ ❑ Special Devices
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEESCHEDULE
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
i uc iviuui��u�a o�iuu�ca y,cot�.l�ro "� St $ Building Permit #
"SURCHARG�" has been changed for one
year effective
• July l, 2010, until June 30, 2011. EATING PERMIT FEE $ ��
The miaimum surcharge for a"fxed fee" permit CATE SURCHARGE $ .50
�s $s, beginning July 1, 2010 DTAL PERMIT FEE $
Th.�.. A.r.r..,��.,r., C+....+...r�� �
This Application Becomes Your Building Permit When Approved Paid ��/� c' t No/ /. n?
J`r 10 K ULJ
Datej .� -��
Buildine Official Date (p '
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372