HomeMy WebLinkAboutMech Permit 02-0480
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
#,--537
Date Rec'd
5~3-0L
~. ~e~n ~:~ PERMIT NO. /)/' '7 -/ fOd
3. Yellow Applicant (/~ V71l (
(Please type or print and sign at bottom)
. ADDRESS
/8 'IV; 1 OtlJ!., R1df-}re C'( f'C,le (~.Ii.
LOT I~LOCK ~ ADDITION (j(V{ J0.d92 aT (~\
f/
Rfll;Y lhuscJ1
~ (jltJe) a(~ (~i-Ju
APPLICANT II....) ~ /J. / / II I ./{',J
(Name) H!d U U ff! r L, !l6, (Phone) '-f '-f (') ~/( t(fj
(Address) (~g.-J JAO. (~f, W. dDf;C:J.jw~J fJ1/J 5S37Q
(11 /\ I '/_ J (Address) , (City4) I 1(' _(/) IV, (Zip Code)
(Contact Person) li.fJtJa /1 /') A ,,\_ I --.., (Phone) '-f ) 1'-1 UV
APPLICANT SIGNATURE I L(~ijJJ j~Ll/ L~ DATE, YOa- ~r
APPLICA~T PL~ASE COMPLETE BELOW
DNEW CONSTRUCTION B....REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL \i1-e..n n(\.~ G I\/\,\q CJ FUEL n('t {-
FLUE SIZE RETURN OPENINGS INPUT ~O: tv.......Cj OUTPUT ~ OD<=L-
ZONING (office use)
~/S[)
LEGAL DESCRIPTION (office use only)
PI~ 5- Dct j- () ?:J 7-()
OWNER
(Name)
(Phone) L/L/'7- Y 2Cc8
(Address)
TYPE OF SYSTEM HEATING OR POWER PLANT
,8Varm Air Plants ~(A.<L€...> 0 Stearn
DGravity 0 Hot Water
o Mechanical 0 Radiation
.@ir Conditioning 0 Special Devices
~ ~t~ent. System. . o Other Devices
~rLf\~C~AKEA~MODEL~(\tru0~\OD-\ ;)-\l:r- -\-un At;
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
I' REQUEST FOR INSPECTION
$ SENT TO HOMEOWNER
: RESPONSE - CLOSE FILE' NO
4/2003
,erations
$39.50
~
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $4CXX) ~
Builamg rCl1un "
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 89/00
$ .50
$ LfJls Of'l_
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
I/O pO Recet;/~11
,-~-b-~ By , ffJ
V
Date
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245