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Mechanical Permit 13. 0410
5 0 0 @ 0 00000E 7 0 › K g O ■2 o $ 0 � � m Wiz@ ..c0 m m m m0 k / / 0 0 \ � � / §�- Z � � o � * \ \X, 2 $ dQ�Q P Zk m t *>, a 0) g z z § xi ? o § ¥ o 0 % k 7 2§ k A 1 0 > 0 7 0 r § - 1 I "V 'V L • m oo 000000 Z m � m m ■uci _ m - o x \ i _ X -o 0 0 m 0 m ] T.000 0 m r -noo 73U k � Z m • z m . r �� 0 o 2 a $ \ . ��� \00000. < m Z t22§§ § / 0 : mM30 2 2 e > m ���o \ z } »km%7 § § -I E @ zr k z m a 0 r I VRlo CITY OF PRIOR LAKE Date Reed o faP x,3//3 � kie 4 ' HEATING /AIR CONDI /FIREPLACE PERMIT � j:rx DTI NNES� , 1. Folk File 2 Green City ( 6 PERMIT NO . :4410 . _ 3. Yellow Applicant sss...//// (Please type or print and sign at bottom) ADDRESS ZONING (office use) 379 ,5w 170 Of ?\O � e X370. P LEGAL DESCRIPTION (office use only) ,, �. , LOT .� BLOCK 7- ' ADDITION 4 V-�ieGl c / 74-ret2 PID r - 2 0 , OWNER (Name) GA n 10 ©l v'� -' 6e/k ew loda ) / r l (Phone) 9 /° t ccA) (Address) `7(Q�,rj A, f • • R) c3 v t t 7; APPLICANT 0 1 1 \ COO 1 Nn c) (Ph one) % � 0l 8 f 7 (Name) �C C �t.51 G � �I (�C�\ (An a \ Q (Address) 3 6 e J Q /eJ` f� LCC ` N. 1 Kct 6 ) ( ddress) (City) (Zip Code) (Contact Person) e . n \ ^ s �' l (Phone) 9 / (Loco Q (5 7 APPLICANT SIGNATURE . 111W/ 1 Y1 I f)CYC DATE &"8 l 3 APPLIC • T PLEA S COMPLETE BELOW ['NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL ?Qy V"1 e_ " P CS FUEL Mc� FLUE SIZE / ' I RETURN OPENINGS INPUT 88, 000 OUTPUT [ 1 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 ['Air 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 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 A $49.50 Estimated Cost $ Building Permit # 1 4, Do HEATING PERMIT FEE $ 7 J STATE SURCHARGE $ ,,,i 31 00 TOTAL PERMIT FEE $ ; - 5i/. cD rT /� / (Office Use Only) �' / t� ` This Application Becomes Your Building Permit When Approved * Ott , ,-- 0. (0 0 Rectl ID Building Official Date g e ' / 13 By5 24 hour notice for all 447 2 inspections (952) 447 -9850, fax (952) 447-4245 / & � r 0 0 P �1�' - 4646 Dakota Street S.E., Prior Lake, Minnesota 55372