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Home My WebLink AboutBldg Permit 00-1035 DATE RECEIVED CITY OF PRIOR LAKE II. z.. C> () BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 1. White 2. Pink 3. Yellow 1. DATE Ej DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 2. SITE ADDRESS /7.;l~~ Jt:J.bt:='~.ez..<:J ~JI!/P~ \5~ 3. LEGAL DESCRIPTION LOT ADDITION 4. OWNER 5. ARCHITECT //-~ -t?t::) BUILDING I 11. SIZE OF STRUC RE (Height) (Width) (Depth) Rl 12. NO. OF STORIES ~ BLOCK / Y7.-..c""'T ~~ ~1V..!l (Name) (Address) PID 25- 372-- OD2-0 13. TYPE OF CONSTRUCTION (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE (Name) (Address) (Tel. No.) 6. BUILDER (Name) .0.-'(. ~)'t:)~ ~. (Address) (Tel. No.) ~.y~ ~~-'V Jt::Attf{ .::s >e-~o.,t' ~~ A:;vv ~7S?Gl 6.:57--l~~-?-""~ 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS 7. TYPE OF WORK New constructio~ Chimney 0 Misc. 8. PROPERTY AREA OR ACRES Sq.Ft. Fireplace 0 Alterations 0 Septic 0 Addition 0 Deck 0 Finish Attic 0 Re-roofing 0 Porch 0 Re-siding 0 Finish Basement 0 SEATS 16. PROJECT COSTNALUE p-v; ~~r 17. COMPLETION DATE 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE Yes No I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revoke this permite just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X ~. ~ ~ oI'~~s7 ......",./..,;:t./-'" , Signature License No. ' Dale SETBACKS: Required Actual FOR ADMINISTRATIVE USE Front Back Side Side MATERIAL FILED wffH APPLICATION SOIL TESTS 0 ENERGY DATA 0 PILING LOGS 0 PERCOLATION TESTS 0 USE OF BUILDING BUILDING DEPARTMENT VALUATION ~~A OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION ~s;./'lO(:) _0 0 o PLANS & SPECS 0 SETS SURVEY 0 COPIES PLOT PLAN TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R Division 1 2 3 4 Permit Fee ................................... $ S U City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ......... .. .. .. .. .. .... $ Sewer Tap ................................... $ $ 8SC.O(L It I () 0,0"0 Plan Check Fee ............................. $ 8SlD. 00 SSe,. CfD I.{'}.S"O State Surcharge............................. $ Penalty ....................................... $ d5" 0.. ~ 100,00 ICO.oo 3S. S'O.- Pressure Reducer .......................... $ Meter Hom ................................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $---J . ?~ ~ Water Tower Fee ........................... $ , ? ()A -- Water Tap ....... ............................ $ Builder's Deposit ............................ $ ... 0 Other ......................................... $ Total Due .............................. $ ~ 755. 4.() ReceiptN2. 3~?_~ By (J'} Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ Issued /25.00 Paid Date I ? -( s-- ?,..o.. This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when s~an~atemporaryCel1iZ~fiQ)mPlian~aIlOWS'*~V~ ~rN~:~%U~s~ ~ ~~Ianner ' Date ~ ~ Special Conditions k any - l 24 hour notice for all inspections 447-9850 Tho COnI., of Iho Lib Country OD<-'03)' White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED D Ie. I I-- I HO/2 I UN z-oa The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ./7744 l)ee.e-Fl~LD DI<. se; V Accepted Denied Reviewed By: Comments: Accepted With Corrections iLL Date: 11-/3-6b .5~z:! $/l//f} ..~k:: /- foe Cohl"fJe';t/73- "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." ~ OU;(03{ The Cenler of the Lake Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED O. Je.H0/2/0Al / /-- z - 00 I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /7744 oee~ReLD DR- S6 . Accepted Accepted With Corrections Denied Reviewed By: Date: Comments: "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." 00 (-- 035' Th~ C~ntu of .h~ Lake Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED D Je. //-. I HO/2 / UN 2-00 The Building, Engineering,. and Planning Departments have reviewed the building permit application Jor construction activity which is proposed at: . ./7244 /?ee.e.FI~LD DR- .56 V Accepted Accepted With Corrections Denied Reviewed By: LLL Date: 11-/3 -C{) ..5F~ /f)AJA} ~eer r:~ G~3- Comments: liThe issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid. II GREEN - I'ILE YELLOW . A....LICA..T GOLD - CITY CITY OF PRIOR LAKE SEWER AND WATER PERMIT S.w. No. 00 -/035 NOTE: Sewer and Water contractors must be registered with the City. APPLICANT: ADDRESS: Genz Ryan 14745 S. Robert Tr., Rosemount SITE ADDRESS: 17244 Deerfield Dr. 00-1035 PHONE: DATE: BLDG. PERMIT # PID# SIGNATURE: FILL IN THE BLANKS 1. Estimated length of water service feet. 2. Size of water service inch(es) . 3. Location of any couplings from structure feet. 4. Type of sewer pipe. ABS PVC Cast Iron 5. Estimated length of sewer line feet. 6. Clean out (if required), located at structure. feet from ------------------------------------------------------------------ ------------------------------------------------------------------ This application becomes your permit when approved. BY DATE: ------------------------------------------------------------------ ------------------------------------------------------------------ FEES: $ $ $ 35.00 .50 35.50 Sewer and water line connection permit. Surcharge TOTAL * Fee for either sewer or water individually is $j?~ plus $ .50 surcharge. * Sewer and water permits issued for new construction must be recorded on the building permit card at the time of issuance to insure that no duplicate sewer and water permits are issued. DATE PAID AMOUNT PA This permit covers the double fee for the sewer and water. REC'D BY Paid by Genz Ryan check #0073412 dated 1/29/2001. RECEIPT # 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245 An Equal Opportunity Employer JRN. 9.2001 12:38PM GENZ RYRN 6513226147 NO.225~.15---- CITY OF PRIOR LAKE , . PLUMBING PERMIT ,Applicant ~... ~ . : ~ Add,.: 'U14~ L ~ ~ ~i Signature: IA.._~~ I. : ~ga1 Description: Lot _ 2- : .Black I Site Address: \' 7- ~I..{ 1L~f A~ T'"\ 'U~ J. 'Iae .. l.Cia!d'Qy 3. y~' AppllCII& # OO-/O$S- Phon.:Jp~ l-t.l~.. I 'U 4, ~~~'~L& 8Ub~~'~n SF Buildin; Permit # ,P!D # N"", I 1:: This permit will not be prcceaaed withoUt complete information. . '. FIXTURE UNITS n. c...... ..' die "'u Call1l., Quantity \ \ \ 'Z--. I \ I 0"-.', . ': .-z, " :../ ~'. '.~ . ' , ........~ "":> .' Type of FIxture Bath T~b witH or WitlqoLlt shower Dishwasher , Floor Drain ! Lavatory (bathroom sink) L.aLlndry Tra~ (1 or 2 compartment link) Shower Stall Sinks Bar Sink Water Closet (toilet) Q~antity I .! I ~I r I I, . " .": .' Type of FIXtUre Rough-ins, Water Heater Water Boftner Stand Pi~e (washing machine) . ~ewage Ejector. Backflow Assembly (APE, Double Check, PVB) ~ackflow Assembly T. Lawn Sprinkler Other . . t $ $ -I FEE SCHIDULE .~ IndLlStrlal, Commercial I Multi-Family (1% of jOb.cost, $39.50 minimum) Residential, New One & Two Family ResIdential, Additions & Alterations state SurcharQe $99.50 $39.50 $. : I I .50 GRANDTOT~L Thi, permit il JrlllIied upon the e:l:prcsl condition that Iald contrK:tor, shall comply ill III resp,er:tI with the' circlinanc:a of me SlaEII PlUrnbinl~O 7!i!: en entl thereof. - . RB ../. ..OLDATE I .. - A Tl'BST Call for all inspec'ons 24 haurs in advanc~ $ .- $1:' ,,~\O\NXRWWl' , ~\\D\\~G. ~. , 16200 Eagle Cree1.c Av. S.E., Prior Lake. Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-42~5 . An Equal OPJDQnuIlity Emplo)'ar ' . - JAN.29.2001 12:32PM GENZ RYAN 6513226147 NO. 037 P.11/13 -- . ..... 'nL&.DW . -.ucuT QOLD . an CITY OF PRIOR LAD SEWER AND WATER .r.r.oI.'dUT NO. CO... 1035 NOTE: Sewer and Water contractors must be registered with the city. APPLICAN'1':J~..;"V\.;l,- ~ Pt~\IloX.,.. l..ParlA...l(,..." PHONE:-"'~I-I.J.2.~-' /44 ADDRESS: 1&.I'c.j~ 1"' -r~1 f<p'S.~r ~'"~ DATE: I (rz...q(("\ I SIGNATURE: U n ~ BLDG. PERMIT 1# Oc -f03/5 SITE ADDRESS: \\2.W (,~pA~ L~ PID# FILL IN THE BLANKS - , Estimated lenqth of water service ~ , , c Size of water service inch(es). 1. feet. 2. 3. Location of any couplings from s~ructure feet. 4. Type of sewer pipe. ABS PVC ~ Cast Iron 5. Estimated length of sewer line ~r feet. 6. Cl~an out (if required), located at feet from structure. --- -- --------------------- ==-~a-----==~-____== -"".== =~---=-~=~----- o ~Alour pe~it wben approved. .,fL D~TE: 2-.,/4-';0 I This application BY _==_____=____.:z.. ._, "' ...z:r.:z--==__==:::;;====iIIiiiii;;::;;==%;:= FEES: $ $ $ 35.00 .50 35.50 Sewer and water line connection permit. Surcharge TOTAL * Fee for either sewer or water individuallY is $20.00 plus $ .50 surcharge. * Sewer and water permits issued for new construction must. be recorded on the buildin~ permit card at the time or issuance to insure that no dup11cate sewer and water permits are issued. ~ \ p,,\O 'l'J~~RMrt DATE E'AID AMOUNT PAID 6U\\PlNG ~ Co R:ECEI!'T # REC '0 BY '- . 4629 Dakota St. 5.E., Prior tBe, Minnesota 55372 I Ph. (612) 4474230 I F~ (612) 4474245 AN EQU^L OPPOFmJNI'l"t' EMPIDfER CITY OF PRIOR LAKE Me 16200 Eagle Creek Av. S.E. Permit No. () 0 - lQ.35 Prior Lake, MN 5.5372 - HEATING APPUCATION ! PERMIT Date 2- '7J.~) l D I PID #I - J I . (\. Site Address .J.:L2- L\-tl.- l:dU"v 11 ~ (d1.) r Lot .-1:.. Block \ Addition Ownsr"s Namel">f2- He) (te; t\ Address ~f5ClY~~~Lw;tj+Dl~7::.~,~ 2D~ ec~CU1 Hea1ing Contractor k t UO..,n::r Iv l-tC.J it n I C ct., ( Add,... ~SD. ktJ1n~beGDr .:Jt- I WjJ1 MI\1 56172- Telephone # 11~) I 4'J l-- - 1"11 S Furnace Make ~ ~~.I ~~UPJ.:L~ Model Size 3K ')k/tVb I.--r{~ i D Conn. Load ---1- , .~ 4-.0 ) . Fuel fJC\J _Flue Size ~"Uas'"SB 8 4 TYPE OF ~ I NUCTURE 2.. Or_ 3. Ycllll... City CoIltrBl;1Dr ~ ,. ~ rf Single Family Commercial Two-Family Industrial Multi-Family Other ~ co co Public .. c to Fee Schedule l- I- " c Industrial. Commerclal & Multi-Family Residential, Heati'lg & AC . Residential, Heating Only 'vl/v?512.2Resiclentialr GIS Fnplace Ae...:J,;.. ,&~ I Additions &. Alterations Residential, AC Only 10/0'01 job cosl ($39.50 minimum) $99.50 PLEASE NOTE: ~ $64.50 Air Conditioner Units Canm: $39.50 Encroach Into Required Side ~ ~ $39.5C Yard Setbacks. ~ $39.5C ~ ~ c: TYPE OF SYSTEM Warm Air Plants Gravity Additional inspections will be biUed at $35.00 each. ~8chani~l. lL .,..i.. "" ~ House Healing Tes! Record must b& submitted with wildina I2IUI1il number befo~ build. Air eand"ltlomng .oVli(u' JI t..- ~ U ill_. ing certificate of occupancy will be issued. Vent. System '2- -5'V r f~t FidtJ RUoI $ tiEAT CAlCULATln~ REQUIRED with number of supply and return openings fisted per HEATING OR POWER PLANT room with CFM's per opening. New structures or additions send floor plan with supply Steam and return locations shown. HEAT LOSS CALCULATIONS, PAVMENT AND Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 16200 EAGLE Radiation CREEK AVE. S.E. PfllOR lAKE. MN 55372. ' Special Oevices _ Supply Ope-nings Return Openings Input '1V: btlt; Output 5u, eve Edr. . Clm.. () l~;{' ou.-} Other Devices TYPE OF WORK Alteralions New Construction v Replacement Est. Comp. Date Bunding Permit " Repair Est. Cost $ 06;/OSb HEATING PERMIT FEE $ STATE SURCHARGE $ TOTAlPERMITFEES $ . pp.,\O \N\~r"lrr O''''G't't:.t\\.., aU\\'': I'" Receipt 1# .50 Remember to add the State Surcharge on (he bottom of this application. The price of your heating permit 'Includes one rough-in and one final inspection. r' l- I- .. e: '" " ~ l- e: ~ ~ := tr Clly Hall business hours are 8 a.m. . 4:30 p.m. ALL WORK MUST BE INSPECTE.D (ROUGH-IN AND FINAL) . CALL CITY HALL 447-9850 I hereby apply for a mechanical systems permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the city and with 1he state building/mechanical codes; thai this form does not become a permit until signed by lhe BUILDING OFFICIAL; that the work will be in accordance with the approved plan in the case of all work which requires review and approval ot plans. 4~>>~ ~lWuru,y~ (11f~) I u {jAPPli~~ Building rrs Signature P.L. FA)L 447- 42...48" .tJw 101 Date --Z ,- z.l~ ,. () / Date ~ <:: <:: I- PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITEADDRESS ~ p~~Jle.0.. U. NATURE OF WORK ~ USE OF BUILDING SFI+ PERMIT NO. no- 1035 DATE ISSUED ll-l"'3- '20C'0 CONTRACTOR ~a.r (:'".e..4t ~S{ - 25G. - 7/ ~ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE I FOOTING I A, 111z./ot FOUNDATION (Prior to Backfill).r~ I ~ 114#/ I fir, III Z/6J PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SI~ ROUGH - INS rIJ W ~;;!. (2ft 31lolbl A. 1/3/1J I ~~ f 4/9/A/ . , I ( " SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING Lo.t.... t.tA. rt?r HEATING (if required) FIREPLACE . GAS LINE AIR TEST I Lf.. / () - 7<M 1/1r/v( tJ ~ ~ d~/dl I . COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED , $J.P~ ~ IJJ~ki ~ ;,IISMJ fA, 31~/f)/ , . " FINALS . GRADING (Prior to Sodding) _ - <:; '" 'Y _ .~, j. h) 6' _ BUILDING'tc..o,~ efJ JaLJ>:::; IRt/ /6/ ~ d' /~/tJb ELECTRICAL (~ ;1 PLUMBING r(/:} . cr/i ~ft( HEATING th- / $/3! I~ ( .... DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED NOTICE This card must be posted near an electrical service cabinet prior to rough-in inspections and maintained until all inspections have been approved. On buildings and additions where no service cabinet is available, card shall be.pLacec:! near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (612) 447-9850 Z TIMe CITY OF PRIOR LAKE , ~./../ INSPECTION NOTICE SCHEDULED...5. Q~Q~ / 7,2f/~ harj)~;1 Llr ADDRESS OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION ~~NSPECTION COMMENTS: h:'- CONTR. PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL a? - /~.3S- o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o ./ ~ - filL" <...-/ ('- - - ~ / ~/ " C-/o s-a --- ~K SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ) fr 1.(( ./ ~ ~r/ Inspector: ~ owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY! INSNOTl DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ~3/b 4/0-0 ( OWNER J 79-1'+ ~ CONTR. ADDRESS PHONE NO. PERMIT NO. f)() - /0 3~ o FOOTING o FOUNDATION o FRAMING o INSULA TIOtfll}\) J! FINAL ~ o SITE INSPECTION o PLUMBING RI 0 EX/GRAD/FILLING o MECH RI 0 COMPLAINT o WATER HOOKUP 0 FIREPLACE RI o SEWER HOOKUP 0 FIREPLACE FINAL ~ 0 PLUMBING FINAL 0 GASLlNE AIR TST ~;rMECH FINAL 0 COMMENTS~ ~~- k.c ~. ./trr.:Td ~ 6 . ~~,~~~ r ~.. ~'. ~-1i:-fv'~.A --h ~ J\I!M. -.'.~~ ,~. / r . -r:~. 0, -f:zil 8/ { /0"2- ~ ~//t~, ( - ~ ~x:J. o WORK SATISFACTORY, PROCEED f CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: -b ~ Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl lNSNOTl .---'~~- -.-- ~ ~:. ~;~i!~~~;'~.~~;,t;;'~;"i.}t''';.,.~.' t ~~ QLtrtifiratt of OOcmpanry (~; CITY OF PRIOR LAKE ~'~~ Jlepartllltnt of .uilbing In'pution IS' ,4 Final Permitted 0 Conditional c.o. Expire. ~i.'-.("._...,.'. ~ This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code ~ .. 11 certifying that at the time of issuance this structure was in compliance with the various ordinances. of the ;l'I; City of Prior Loke regulating building construction or use. For the following: ..~!~ '!ir .\' -I "~~(i } 7.'., I (~~~ t.- i ~'::~~.' <<.,.. ~":. l~1'.......f.'.- ~., :: :-. .~. Use C1assificatiol' SINGLE FAMILY 00-1035 Bldg. Permit No.. Occupancy Type R3 N/A Zoning District R1 VN Type Construction _ Fire Zone' L2, B1, DEERFIELD SECOND ADDN. Legal Description Owner of Building c;ite Address 172 44 DEERFIELD DRIVE S. E. Contractor'sName&AddresP.R. HORTON, 3459 WASHINGTON DR., SUITE 204, EAGAN, 55122 ROBERT D. HUTCHIN~c, PI DON RYE . / Ity anner Date: Date: ............ ~'i'l .Ii,-l...~,~~'.' '';;'''''~~;'''''' .;.-,,~:J'I"II ,,' '.. ",... I,' ,,', ,~. , \ .......... , .-....., HOUSE HEATING TEST RECORD ,',ADDRESS J /JY~ f)-~,.'--.,t;"h\ OR,..5~ OCCUPANT_ t/ HEAT LOSS _ .DATE HTG. INST.!/-/J -/>-, SOLD BY Elech'ical Work By TYPE OF HEAT GA _FA .Y .HW_ STEAM _ 1( ///1. .9AS DESIGN MAKE /)L/'h /1// Model ~/9'U OC/::J 07'/ Seria I IY 00 /9r)() 'i '/ INPUT --Ii ~ . CONTROLS THERMOSTAT f/~r,-4 /1 Heat Plug Valve (..> , I, Limit f ~ 0 L. 't Sett' I I l 1m. lng' Fan Setting Pilot Type Pilot Make Pilot Model Pilot Timing L.W. Cut Off Pressure. Input CFH Stack Temp. Form 235 J I /~YI ~. / ( / I I \ / / I 1../ /' '1.t, .1 -:-? "/ """')q -5 {/; " t.I {. . Percent CO2 Percent 0, Percent CO" /, APT. OWNER FLOOR .JOB # CITY SUBURBh~~ / ~Irr Gas Line By SPACE HTR. INSTALLED BY $//;' /7; (' // --' KIND OF LINER Draft Hood Filters Size /.:,,// tel Chimney Location Insid.. /// p' I Chimney Construction ./ ./ .-// \ /i q~ /7 - /"7 Frederick$On Heating & Ale, 3650 Kennebec Dr., Eagan, MN 55122 /.<//;;.. . UNIT HTR. .MAKE OF BURNER Madel Max. BTU Rating _ MAKE OF FURNACE Model / ./1, /f \ Vent Size Smoke Bomb Draft . Door Pressure Date Tested Company Testing Name of Tester OTHER CONVERSION SIZE _NONF Regula,oy-#f7"k'/ T ,.{::::> Number Outside \r Wiring _ Test Tag Lighting Inst.