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Mechanical Permit 13. 1030
J 0 1 n 000000 = 0 >45 g $ n n n 7 xi m ° . � kk� kk § k omo § r q 2 2 z � § § 2 � � ® r n n ® 2 - o� Q P 0■ to t k § 0) 0 Z , § 79 n B -I a o R' § q m�` m % -71 0 r z § § 7J r � I zm 7377 § \� 000000 .I x m m mSICE � � � c Q ° Z § MX § 0 ' -k. a) § G § m03_ 7373 ;3 ! B � § � � s o P. o . r ,i § o m � D z 111 > cc z � � r § § P. r § P m r. 5 m o n § 2 7O ❑ ❑ OO _ m o § Ua2 § § ' �, • R. ni v ® §C \ >z k / oA \ ozy § 2 � - m2 ,� E o 0 - ) 000000 - o ) - n k o o * . 0 � �-g� mn 0 m 5 § / . � ■ � ■ s ,-cEa§ xi § �� m m § k* o■ 6 ■ -0 ® P� © Z $ §oqQ P �k % q m o z co k / 5 0 dk » k � n � o � �� % 73 73 7 �) mr 0 73 73 z 73RR 7 OOooOO m m m m s » mr x m m m Eo -1 f m % � ■ � 0 t ca CI M ® d > 0QO0 k m . n 0 o r -n § o 73 r ® / « w51 zxx z c z K RI' o 2 1 7 1 .m o o . P § m . '0000O � .k."5-4 k• 2 :Limn § 1 > a. o c1,�v$ cp• _ ~� NI\ o � 00k- § 53 !!2E -I§ B rn 7. c....V 4 vRtoCITY OF PRIOR LAKE Date Re�c'd Cr `'' ' �' HEATING/AIR CONDITIONING/FIREPLACE PERMIT 9, / 7..if3 . Ai 'MvEso�A I.Pink Pae PERMIT NO. /3 _ /0�- 2.Green City , 4� 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS • ZONING(office u:e) 4 Li 1 I Pond) v l e,+-o Tra i IE-' . • LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID ZS-. 3.A7. 6 I 0 OWNE((Name) C\f 1 S 1 t a h 1 a 1,0 Ok.1 G{ (Phone)gsa Cl D O3t) (Address) 14 J 11 P(JT d VI(',LA.) Tv- 1 Se . APPLIC4,,I • n (Name) 1" \1 Nn-ZSLI�GA. a rvr,. i t 1 C� (Phone) '?3 Ci y 9 S Li I `7 - • (Address) I 48f° t ' 3 Q. S ?--,_-c SST/9 �,/�,� ( (Address), ' , ,�� (City) l (Zip Code) (Contact Person) `W Z ICSki Dtd /Pa" Stet (Phone) 63 � —/ S— yiVi'l g . APPLICANT SIGNATURE Ili iiiiiiiilii, DATE -! 17 h 3 _ 11'PLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION VEPLACEMENT 0 ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT — PLEASE NOTE: Air Conditioner ❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach ❑Gravity 0 Hot Water into Required Side Yard Setbacks. ❑Mechanical ❑Radiation 15 stir Conditioning El Special Devices Fireplaces with Box Additions or :Went.System 0 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 $49.50 Estimated Cost$100 Building Permit # The Minnesota Statutes§32613.148 Ci.O "SURCHARGE"has been changed I'Gr one HEATING PERMIT FEB $ L( year ar eiTective STATE SURCHARGE $ S.00 -SO July 1,2010,until June 30,20'..1. TOTAL PERMIT FEE $ ,C V.S ) The minimum surcharge for a"fixed fee"permit (Office Use Only) is a5,beginning July 1.2010 This Application Becomes Your Building Permit When Approved Paid Jr-. ca Recei t No.i 0 U / Date 7 '— /? By Building Official Date , 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372