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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
; ~e:n ~~~. I PERMIT NO. Ur 7 (114- I
3. Yellow Apphcant . ..
at bottom)
ZONING (office
use)
ADDRESS
3b9s
/70/4,
GJ.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
/~,ee'7
;{lC;n/<~~'1
(Phone) qs z - '/'/7.. U-Co
(Address) .3 b " J
70:J-A JI..
&/~~ ~fa,
~~ :JJ"'.?7
APPLICANT
(Name)
(Address)
ANGELL AIRE, INC.
12253 Nicol/at Avenue South
Burnsville, MN 55337
Telephone: 952-746 5200
~'~2.7 46-5202
(Phone)
(City)
(Zip Code)
'::ontact Person)
(Phone)
APPLICANT SIGNA TORE
DATE
ANT PLEASE COMPLETE BELOW
/
DNEW CONSTRUCTION )2r'llliPLACEMENT o AL TERA TIONS fi~.
FURNACE MAKE AND MODEL .6~~" f- J /O~d..?.&07\;) FUEL
FLUE SIZE RETURN OPENINGS INPUT 7 (J. IJ# 0 OUTPUT ~ 0 c}.1Q
,
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
~echanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices 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 & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
Building Permit #
$ 3<:1:
$
$
,Office Use Only)
Date
Paid 40, LfU
Date / (. [& . ()
NO'SSV3
This Application Becomes Your Building Permit When Approved
Buildinl! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245