HomeMy WebLinkAboutBuilding Permit 10. 0473 t
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CITY OF PRIOR LAKE Date Rec'd
° , �' HE ATING /AIR CONDITIONING /FIREPLACE PERMIT
H X. Fk, d6-- -v" ( 0
,. P dre F11e PERMIT NO. I v _4
INNESO�P 2. Greco City
3. Ycllow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
\ 133 1 l C) Id 1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER (Phone) (11% ? J�\ s /
(Name) c -PSSe, \M �e\
(Address) 1b\ `. vC, 1 `�—
(Name) ) 'L' I U r 1 \le WI (Phone) G a _I J � - 1 9
0� `'mot / -) 5
(Address) 1 --° t
I�/ r �, I' "
(Address) (City) (Zip Code)
(Contact Person) i , I�/� )L SU\ \ O V� (Phone) &L ( / �] /4'14
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION lit 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.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
it Conditioning ❑Special Devices Cantilevers to the Outside of Buildings
❑Vent. System ❑ Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi- Family I% 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) $6 Residential, AC Only $49.50
Estimated Cost $ 3S d Q ! Building Permit # ` 0-- LV-13
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 2
(Office Use Only)
This pplication B°conhes Your Building Permit When Approved Paid Receipt No.
5 ^� O "o -( ( Date By
t ldluc Ofilc al Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372