HomeMy WebLinkAboutMechanical 05-0197
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CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~:~~;v E!~ican, I PERMIT NO. (] 5 ~ 0 (Cr1 \
at bottom)
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25' 4-
. C570
OWNER
(Name) SLfF. d H A-65~11
(Phone) Q5Cj, 895- 579{)
8
.
o
J (Address) i l....1 J 7 7 Co '-'I 0 fee I r ,-I E.
APPLICANT
(Name) C. 0.. + f' (;; iI E d A ,.--
(Phone) <:05 I - L-j /.00, l.DD.y(J
(Address)
a/170
E::. A- ..J-o.. A L1 L 6uJ hA
(Address)
)- 0. r..-n 'Rto,",
550214
(Zip Code)
(Contact Person)
(phone) 105 1- 3 L/L{- LJ ~53
DATE (b- JR. 05
CANT PLEA E COMPLETE BELOW
APPLICANT SIGNATURE
DNEW CONSTRUCTION lR1 REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
gAir Conditioning o Special Devices Required Side Yard
OVent. System gather Devices \-tv"'V\\ 6 I P \~.... Setbacks
FIREPLACE MAKE AND MODEL .
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # (.:;,- OICJ '7
$ 3G.5o
$ .50
$ 40,00
(Office Use Only)
Date
Paid '" 'I (, '''I
-re. . l
Date ,'~'" I r' r--'
J, ~ . 1.1 -2>
Receipt No. 1-88 E~
By
This Application Becomes Your Building Permit When Approved
Buildinl! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245