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Mechanical Permit 13. 0148
— 0 0 0 0 000000 7 0> /0 ¥ 0 0 0 co � - mm 0 0 k r k k - � r E } § z \ \ k m r rn m co m z 2 o z % t 1 - > 2 $ --10>0 P 2� a -( m o 0 \ -4 § \ / 5 i § § z \ 0 m 0 0 o o q§ r- 0 13 41 m k 0 0 Z - nn . 000000 'n m m mq ■��* ■m o o o m[ >m ) K E § � . k § ■ % m 0 _ , 0 zi k m § ,\ >°oo 0 _ 3 -I k m % q § 0 i r � 22 c 2 z \ m - / -o - o P $ m I m q o ` o q m 00000 r 7 � �II §2 -( t § o Q ■mmc0 ¥ \ i ,i'4 k ���§ j £ k § § � r - \ 0 z ■ & ®r 0 14 I '- 09 q 4- / VRl CITY OF PRIOR LAKE Date Recd HEATING /AIR CONDITIONING /FIREPLACE PERMIT !"--: ',: ' ':.. x $ c --- SO CJ L) N �P 1 Pink File jNNES° 2. Green city PERMIT NO. 3. Yellow Applicant �� _ ©/� j/ 4 (Please type or print and sign at bottom) ADDRESS ZONING (office use) 5 A rthk wood Dr \c- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (IIZ /1 (Name) r a L.t. M (Phone) (Address) 5369 A bk Dr N C APPLICANT GC R MOD ' � \ 1 I ,3 ( (t`1 fY (Phone) / (Address) 2ZO0 1 --- W 3 � 1 j, S533J 4 (Address) bo (City) (Zip Code) (Contact Person) i\ L 1 l . (Phone) q C J? 1 • 01 APPLICANT SIGNATURE I _ l DATE 2 / "" APPLICANT PL ASE COMPLETE BELOW (e Pace. f (Ariftcc + ['NEW CONSTRUCTION p ) 'EPLACEMENT . 2 ALTERATIONS (�� FURNACE MAKE AND MODEL - .1 1l SL C.� t Lk 090V V 3[p 3 FUEL CA S g �\ FLUE SIZE RETURN OPENINGS INPUT OUTPUT l c °OV 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 ❑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 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 The Minnesota Statutes § 326B.148 Cost $ Building Permit # "SURCHARGE" has been extended LJcI S 0 until June 30, 2013, HEATING PERMIT FEE $ / _ The minimum surcharge for a STATE SURCHARGE $ "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ 5`- , S This Application Becomes Your Building Permit When Approved Paid j -y s l Receipt No. 6 f mT ._ i Building Official Date Date 7 n By 24 hour notice for all inspections (952) 447 -9850, fax (952 4 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372