HomeMy WebLinkAboutMech Permit 05-0880
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CITY OF PRIOR LAKE
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2. Green
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Date Rec'd
9-)~-i>~
~:;y I PERMIT NO. 05 (J8 80
Apphcant
(Please type or print and sign at bottom)
ADDRESS
320/ L-/NOGN UK-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
ZONING (office use)
PIDZ.S:- 1+-1. 03/. 0
~~~~~ANT_<) m I S' ~ J{ tf? 6- If (Phone) _~t77 - 7 Y y - -? 3 /' 3
(Address) .:-2 ().R... 56 v rlJ /444/N' 5'/ Lo'? ~ ~ ~ ~5'cP{ b
(Address) ~ (City) (Zip Code)
(Contact Person) (?e./e.4-/ L~ <) ffl { r..e tE:.., . _ (Phone) ~(I?,?Y Y - ..:?.3 ~
~PPLICANTSIGNATURE ~. /?/ ~c;;::? DATE q-/~- 0 ~
/- /-.--- -,. ~- - I
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
~NACE ~AKE AND MODEL FUEL
- .---'
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
DWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$ 39. 50
$ .50
$ 4-0. VV
.ice Use Only)
Building Official
Paid W
40~
Date Date'f./~ ' .f-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
This Application Becomes Your Building Permit When Approved
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt No. H9~f-t
By /ff
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
..?,20/ ~'~~h
OWNER
CONTR,
PHONE NO,
PERMIT NO,
0... TE TIME
%~-
/"?;.--
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D FOOTING [] PLUMBING RI
o FOUNDATION 0 MECH RI
[] FRAMING [] WATER HOOKUP
[] INSULATION [] SEWER HOOKUP
[] FINAL [] PLUMBING FINAL
[] SITE INSPECTION ~ECH FINAL
COMIJFNTS: 1 ___
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[] EXlGRADIFILLlNG
o COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
o GAS LINE AIR TST
[]
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roRK SATISFACTORY, PROCEED
[] CORRECT ACTION AND PROCEED
REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
r
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!