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� PRIp CITY OF PRIOR LAKE Date Rec'd
� �� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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� '. P `�` F ''e PERMIT NO. '/
z. Green ciry I L (y
3. Yellow Applicant �
lease e or ' t and si at bottom
ADDRESS ZONING (ofl['ice nse)
�3 � ��f�r �a� i �V
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
�aWI�TER f 1 i �Y 1 ,� Ul (Phon ) '�� � v �� �
(Address) � �l ��/ � ��'l � I' �� � �
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 inda (Phone) 9 5 2- 4 4 5- 8 58 5
APPLICANT SIGNATURE DATE �" a''l r �
APPLICAN PLEAS COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEA5E NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
a Gravity ❑ Hot Water into Required Side Yard Setbacks.
chanical ❑ Radiation Fireplaces with Box Additions or
ir Conditioning ❑ Special Devices
OVent. 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 Cost $ Building Permit #
"SURCHARGE" has been extended
until June 30, 2013, HEATING PERMIT FEE $ ��
The minimum surcharge for a STATE SURCHARGE $ .50
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid� �I � Receipt No. j a
T !o /
Date � 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