HomeMy WebLinkAboutHeating Permit 09. 0963 - 4736 Tower Street Oct. i b. iUni 1 1 : 1 I AM ivu. ULLki I . 1
CITY OF PRIOR LAKE
Date Reed
4,7 .co. IIEATING/AIR CONDITIONING/FIREPLACE PERMIT
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3. Yaw Applicsuu ( i •
(Please type or print and sign at lboitom) _ --
A-DMESS i ---...., I 1 ZOIsiliVia olti iag)
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______
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IXGAL DE-SCRIP ON (lioo, it. way)
LOT BLOCK ADDITION -- _ _
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OWNR ...._
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(Name) 11-'1 4 (ejeveyd 14
(di) V 7 / 6--- TO ea./1-100- SA r ; '
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APPLICANT
(Name) ._ re;ii t
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(Addre4________7402.W 11 (1.11°11e)
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Eden Prairie, Mitetki134 (
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7:1 Code )---
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(Contact Per3on)
[ _941-104. - /16.111111111111 (Phone) — , S 47 )
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APPLICANT SIGNATURE -- • . DATE -
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APPLICANT PLE i :'E COMPLETE BELOW
[NEW CONSIRUthiON
FURNACE MAKE D MODEL e '1 d.' 0-.5--e-
FLUE SIZE i PC— RETO OPENINGS
TYP4. OF SYSTEM .
*a ann Aft Plugs
I Gravity ' -
0 Mechanical
DAir Cc' Inditioning
ElVent. System •
FIREPLACE MARE AND MODEL
r ,1 • LAcactimt
BEATING OR PO 6 1r ‘i LAN 19' "'
0 sta.
0 Roe vita&
0 Radiation
ri Special Devices
n Other Devices .... t9 D ALTERATIONS
nem eocco FUEL /
OUTPUT _
PLEASE NOTE: Alr Conditioner ...
Volts anti kirepiaces Cannot Encroach
into Required Side Yard Setbacks.
kireplams with Box Additions or
Cantilevers To the Outside of Buildings
Require a Building Permit.
-- - ----- • ----------- .----=-_-__ __ __.1
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1% OfjOb cost Residential, Gas Fireplace $49.50
$49.10 minimum
Residential, Fkating & A/C (New Constmetion) $149.50 Residential, Additions & Aloaotioaa $49.50
ResidontioL floating Only (Now Construotion) $64.50 Rosititaitial, AC Only
Estimated Cost $ 'Oa_ Budding Permit #
HEATING PERMIT FEE $ "),.. D
STATE SURCHARGE. $ 30
TOTAL PERMIT FEE $450,----142-
(Mkt Ilse Only)
VECEIV IL ' -
1 This Application Becomes Your Building Permit When Approved i Hiandblial etelpi N o 9 ,..? r
huadtaeOincial .
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24 boor notice for 1111 ilispeetkuis (952) 447 1 yoja.“952)..44142o.._ i
4646 Dakota Street S.E., Prior Lake, ' ueso a 13,
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