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Building Permit 16. 0314
E 0)6 0 0 n 000000 = 0 a En 2 0 § * ` O ■ 71s -n � -n § $ �� C % Ir � f A2r"c-- z 2 -� -, _ Z - :I G) P 2■ 7 I 2 § $ 111 -4 m 2z 0§ \ / > 0 mm ) kX r § 7 X • 13 73 Xim ■ Z 71 O O 000000 /I xi _\ - tom •e m� m "ocotm - m 77 z ? m al� I z mmxm -0 n ■ 2 ¢ ; . Tit - § z 77 9 41 m 0Q- * m .,.... =Z r$§ § k § 0/ or - I � � z r 0 . r � � P v m 0 0 ■ m oO ❑ Q - OO k © 02 § El kR. > k 2 § \ 2 � 1) -09 ® z ni n mnmoq m -n „ r= _ 1 CO z ■ 4r 0 tsQPRIO 4. ECITY OF PRIOR LAKE Date Reed ,...) HEATING/AIR CONDITIONING/FIREPLACE PERMIT 1 ____NNBso 4, r e 1� 21 PGrmkeen FC1litye I PERMIT Na )( -o3K/ (Please type or print and sign at bottom) s. Yellow Applicant ADDRESS 15 °� '7 V 3 / ' 3XK 01 K Pa - N ZONING(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID (Name)OWNE M 1 c_1(10.0_1-, (Phone) 5Q-113-7- 5-7-1:/ (Address) 1 b 0 3 7 GLjetc__ . (:)./ -r - ME APPLIC• _ A (Name) d. L/ i`_ ■ti AS 1 one) Ct t i1 Z' 2- 0 (Address) • \ \ LEINTA. A. e_, (,. ‘ A A 5 A. ) (City) _ (Zip Code) (Contact Person) it-IC AIL'IC ^ L� +2- L j 7 ► (Phone) 1 APPLICANT SIGNATU' . 1 -%116. DATE 4 '"` T, L 56' APPLICANT PLEDCOMPLETE BELOW []NEW CONSTRUCTIONCPLACEMENT10 ALTERATIONS FURNACE MAKE AND MODEL Lit^A I F� 57/"!N 7,''O&&V/7-7L ///,�C! �� S' FLUE SIZE r RETURN OPENINGS 1 INPUT ��JJa� (CO 1/ /�6— .�(//t:(.�tJ OUTPUT 77 b� TYPE OF SYSTEM HEATING OR POWER PLANT [Warm Air Plants 0 Steam PLEASE NOTE: Air Conditioner jGravit ❑Hot Water Units and Fireplaces Cannot Encroach Mechanical ❑Radiation into Required Side Yard Setbacks. Air Conditioning 0 Special Devices Fireplaces with Box Additions or :Went.System ❑Other Devices Cantilevers to the Outside of Buildings FIREPLACE MAKE AND MODEL Require a Building Permit. FEE SCHEDULE Y 1%of job Industrial,Commercial&Multi-Famil cost Residential,Gas Fireplace $49.50 $49.50 minimum Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations Residential,Heating Only(New Construction) $64.50 $49.50 Residential,AC Only $49.50 Estimated Cost$ Building Permit # HEATING PERMIT FEE $ -17.C`� STATE SURCHARGE $ 1.00 TOTAL PERMIT FEE $ J1,Z0 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid sp Receipt No249,(,3 Building Official Date Date 13 3 Y t cp By c 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372