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Air Conditioning Permit 12. 0686
n 000000 7 0 > E . / 0 § ]K�2 o 0 m 2 m0 A n \ 2 0 � �� a C0 m § q� k § 0 0 % %d§0 . $$ cn 1 0 cn 0) 0 z z 0 2 \ m z 00 0 § / 0 `§ k k . 73 / 0 3 11 ∎ I I -n -0 - 13 m 0 X X � 000000 § § q m . A "0 ® $m2 �� I NF 3 x 3 §§ . . ?&m?■ n @ m -n m 0 0 7 3 K/\ >0o0 0 2� m :1 2 m% 0 �^ r - 3 74 P E 0 6 Z c7 Z m ] 0 / Z @ z ^ > cc 0 � . o 2 m 0 N i / ^ z } 0 . m 0 0000 m m ��nm � b V \ > 0 Q . &K g22 \ m R. 0 Q E� - o � 4 \ z X ', ��_0 -4 zi § $ ƒ \ N c � . • 4 rRto CITY OF PRIOR LAKE HEATING /AIR CONDITIONING /FIREPLACE PERMIT Date Recd 4 1ln'NEsoo File Green city ( PERMIT NO. / (Please type or print and sign at bottom) 3. Yellow Applicant ADDRESS ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) iek --F YY10 rrtC \Cy (Phone) `"s2 - 2.7, J ^ 53 (p (Address) \ Ll, i2 Sl° cl n ` E APPLICANT ' � (Name) !.r. AIL 111 `01 • Le al40111, III % r E' ((Phone) bS( — ZZ'CJ qtI I (Address) 505 2 o-f)d ®( b 1 <1� 1 S t Paul k N FSi (j?__ (City) (Zip Code) (Contact Person) • & PA ( Phone ) O S ‘ © l _ ct CT 22 C APPLICANT SIGNATURE LL /%I, ` � m ' `4. _ -� DATE 0/ 20 / l APPLICANT PLE OMPLETE BELOW :NEW CONSTRUCTION [LACEMENT ❑ 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 ❑Gravity ❑ Hot Water Units and Fireplaces Cannot Encroach ❑ hanical ❑ Radiation into Required Side Yard Setbacks. P Fire it Conditioning ❑S Fireplaces with Box Additions or 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 1% of job cost Residential, Gas Fireplace $49.50 $49.50 minimum Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations Residential, Heating Only (New Construction) $64.50 $49.50 Residential, AC Only $49.50 Estimated Cost $ 17 Building Permit # The Minnesota Statutes * 32613.148 HEATING PERMIT FEE $ i "� �, 0 " S(.}RC:I IARG E." has been changed for one year effective Ju ne STATE SURCHARGE $ �: 0 0 � July {, 2010, until June 3(l, 2011. (Office Use Only) TOTAL PERMIT FEE $ 5 L/ G The minimum surcharge for a "fixed fee" permit is S5, beginning July 1.2010 This Application Becomes Your Building Permit When Approved Paid s9.5 Receipt No. Date B BuildinE Official Date t _c 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 •