HomeMy WebLinkAboutMech Permit 02-0521
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
5-/3-02--
'- Pink File PERMIT NO
2. Green City 'OZ. _/Jr::-?j
3. Yellow Applicant U-.:..>~
(Please type or print and si2l1 at Lv.""~.)
ADDRESS
5~ol
\ f) r2{2 If' f f(J) /l /.-. Q YJ tv
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER "1 G
(Name) !+ CP'\ rp,p-Vl
$dJ) i fJ/J(./V'{!,t~1 d t.an p.
APPLICANT f J ,(). j II} ^ /I f:u ^~_\A
(Name) FiY'~P ~V'''a~ J/f llftJl-CJ]'eJ/~(Phone) Ji$~ --gq/J~7511
3'8"Sn IJ.). fLt,J!J /:2 j2UflY1'JI//J/a IMh/ 3:5'331
(Address) . (City) - ~ (Zip Code)
(Contact Person) _/(, '-t lh'//1 ~ .I') .~ (Phone) $' S.;z - J'"9o- {",)'7._ ~B
APPLICANT SIGNATURE '-~ fL:%fJM DATE ~~/J3 J~1
(/
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TlONS
FURNACE MAKE AND MODEL PER ELSIE AT FIRESIDE FUEL
FLUE SIZE RETURN CORNER, THIS INSP WAS OUTPUT
TYPE OF SY;:)l~N.l APPRD ON 11/14/02. CLOSE
FILE
(Phone) _9 {; f).. - 'I!!IJ - q q I q
(Address)
(Address)
PLANT
Industrial, Commercial & Multi-Family
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit # t'JC.. -0.5 2- /
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3~5L)
$ .50
$ 4d.()O
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Yfl))---. S ,. 13, cJL.---
8uilding Official Date
Paid .J
O. dO
DattL
~ -13 - 0 z......--
Receip\ No.
+- z.. 03" 4-
By -p __
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245