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Air Conditioning Permit 09. 0897
0 1 J .t N. w °g > O p Cei or r 0 2wW0 - 1 S z a 41 W ZO�ita W z o T s � w U u u o > 1 , 00❑❑0�,1 ! > u ''- cr fig--' 3 , nt 4 0 1 O LL N O J m z O 0 '� FE OOLL-J o 2 W o n 000_1 O w W N O d 2= W m S .. p O Z D. - O JW JW W W W W GL a 3 u)a 2 ■ U U a Z c 0000 0 0 74.N7 a a 0 14 - H 'JG1 2 c ( O V 0 LL oC V ✓° ZO , W O � m j V) U � p 01 O z z V N r - - 3 a � ? re o O a Z co w w q a. r.. ... N O ?oz z LLI w w O a U r..... z �z� 2 O o 0 v V o w re w z oo� a 44 z► W - 2 3 " 0 o U) Q 7w 0 0_ LL W = U. U) O ❑ ❑ ❑ c U z a 0 a 0 000❑❑ 0 n cPRIp CITY OF PRIOR LAKE C/ Date Rec'd � . . , HEATING /AIR CONDITIONING /FIREPLACE PERMIT Q rri I P 1. Pink File PERMIT NO . 3 Yellow Applicant �/ VV NNESV 2. Ye City o q . U f/1 . (Please type or print and sign at bottom) ADDRESS ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (N - e-11 S 10 (Ph `7� J'�� J (Address) `TcZ g ri r"h r\cia I e c amh ( APPLICANT Name)) 1 c, �JC S-� I 1 • (Phone) �.X�.C1 Phone q- --- 31 - 10 9 G I (Address) (d -. (>� . 1 4( �- la, A, ppl� v a. \ t 5 1 - , 7 /-�- (Address) Y (City) ' �y (Zip Code) V (Contact Person) -i- ‘ t c ( Phone) q `/ f3 i- < c e4 APPLICANT SIGNATURE aL_____, DATE 10- a 1 APPLICANT PLEASE COMPLETE BELOW ['NEW COnRUCTION K] REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL r I C.-r �g mV c....0 20 FUEL IdCri, I �Cl .) FLUE SIZE l p ti RETURN OPENINGS INPUT RI (D1 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. ©'1C echanical ❑ Radiation Fireplaces with Box Additions or [ir Conditioning ❑Special Devices Cantilevers to the Outside of Buildings ['Vent. System ['Other Devices n n Require a Building Permit. F � MAKE AND MODEA�o - c�4 M �� - t72:4 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 Estimated Cost $ 71 DCX • Building Permit # HEATING PERMIT FEE $ L .5D .50 STATE SURCHARGE $ C TOTAL PERMIT FEE $ . (Office Use Only) This Application Becomes Your Building Permit When Approved Paid - 0 ` n 1 Receip o. 510 Buildine Official Date Date / o . 20 , C 9 By. 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372