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THIS FILE HAS BEEN
CLOSED DUE T
INACTIV 0
ITy 4/16/2008
''Y
~
CITY OF PRIOR LAKE
~ CONDITIONING/FIRRPLACE PERMIT
~QUEST FOR FINAL
iNSPECTION SENT TO
HOMEOWNER 10-06
Date Rec'd
10 (.3/.6S
.
....~
~!~. I PERMIT NO.OS I Ot}. ~ I
Applicant . ~
(1 D~ Sf- 5uJ
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
~J1f <J:,t~ 5Ld
PID 25: q/O OtJZ.O
I
BLOCK
ADDITION
I OWNER ~
O'ame) ~;~
(Address) _
(~ c.fl(o-/3fO
APPLICANT
(Name)
(Address)
STANDARD HEATING & AIR CONDITIONING
410 WEST LAKE STREET
MINNEAPOLIS, MN 55408
(A~11.824.2658
(V1d lJ0
(Phone)
(City)
(Zip Code)
(Contact Person)
.(Phone)
A.PPLICANT SIGNATURE
TYPE OF SYSTEM
~Warm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
<3
FLUE SIZE
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial. Commercial & Multi-Family I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AIC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $ ~ Building Permit #
$39.50
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~9,SD
$ .50
$ f{o .~
lice lIse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 46. 00
Date/O. 31 v S-
Receipt NO..5l23-=t.3
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245