HomeMy WebLinkAboutMechanical Permit #01-0575
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CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FlREPLACE PERMIT
(Please type or Print and sign at bottom)
I ADDRESS
14VJ1d- MaJ\c 'Trtt"1
S&
Date Rec'(
I Pink File PERMIT NO ..-
2. Green City 'y"J/-., ..~ 75
3 Yellow Applicant L/ J"
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LEGAL DESCRIPTION (office use only)
LOT::=f-BLOCKd ADDITION{(JO~t)2~ ,&~ Lff.J1
OWNER
(Name) Mar-'f G.f1)..~n
(Address) 14l.tJ1d- MO.piv 1f(A i' SE:
S{ju+hsjd~ tHg.
I L{~ -;fb... &-: - :# I ry
(Address)
(Contact Person)):::cln W~~..s
APPLICANT SIGNATURE ~ WtiLi~ ~ <:'
APPLICANT
(Name) WM.LeY$
(Address) faq~ W.
PID~S- Ilf-Ol b-O
(Phone) /..ILl'"] - S757
(Phone) 43i-70q~
ft.)nJ~. \/a lky 55Ja-L/
~. (Zip Code)
(Phone) 'i.3 ) -lJ:) c::y:=,
DATE ftJ-7-01
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL -.Carr-jer- st)~IA\JQ.9J - ld- FUEL
FLUE SIZE Co " RETURN OPENINGS INPUT 8'b J)OO OUTPUT 10J LI 00
TYPE OF SYSTEM REQUEST F . - . ''T
DWarm Air Plants SENT T OR INSPECTION
f OGravity RE OIfOMEOWNER NO
g-Mechanical SPONSE - CLOSE FILE
~ir Conditioning 4/2003
A J ( :JYent. System
F::7,l.f~C: I.1AKE AND MODEL Co.-v ~ I -t. t' ~~~ 0 2.0
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
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Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
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Estimated Cost $
Building Permit '#
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PE~\1IT FEE
(Office lIse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$ .3<1. 50
$ .50
$~.a::l.
Paid tl () /' tJ ()
Date/, -11-0 (
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Recei~ No. 0 (]
). ~ 4'~ I 7
BYBG