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04 rRlp� CITY OF PRIOR LAKE Date Rec'd
� � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
� �
�1J 't 1. Pink File
NNESD 2. Green City PERMIT NO 1 �� �
3. Yellow Applicant �
Please e or 'nt and si at bottom
ADDRESS ZONING (ofl�ce use)
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LEGAL DESCRIPTION (ofl['ice use only)
LOT BLOCK ADDITION PID
(Na� m JC�rr�� s 1" ���' I� 1,�� (Phone��ll L�L ��C�"J
(Address�+�� L ✓ 1 1,��' I������ l� `✓�� ������ I.k.��l. 5����
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 DATE
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 5ide Yard Setbacks.
❑ echanical ❑ 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
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 $49.50
tiic rvuuiit,�v�a ��atutca y ��bii.iwd ''" t$ .� Building Permit #
"SURCHARGE" has been changed for one
year effective ATING PERMIT FEE $ ��
July 7, 2010, until June 30, 2011.
The minimum surcharge for a"fixed fee" permit ATE SURCHARGE $ .50
►s s;, beginning July 1 , Zoio �TAL PERMIT FEE $
_..mt--*"'--._..__��_eti_.....__ c ��in 1.e_.
This Application Becomes Your Building Permit When Approved Paid ' Z'f l e eipt No./ _��
J �i l9
Date - /� �
J� .
Buildine O�cial Date � V � (/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372