HomeMy WebLinkAboutHEATING 05-1067
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THIS FILE HAS BEEN
CLOSED :DUE TO
INACTIVITY 4/18/2008
ITY OF PRlOR LAKE
ONDITIONING/FIREPLACE PERl\1IT
Date Re~'ll
~
~-:;;&
i =. 6~1 I PERMIT NO.Os. IOu/7':
l. Ytl!ow ""lii""" , ' .:.1- J
~ type or PMl 'I' l ~!llllt bol!l>m)
I ADDRESS
'333, Woo j) {)u..c.i.. (Jr. N W
~EGAL DESeR ,YfION (Q/lice uu only)
I
I zoNING ,~""., 1
I LOT BLOC: :
ADD1TION
PID 25.337. 047. OJ
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r 0 WN"ER , - I P +
j C~L~e) ;Y\\.~'c.~ e.. L,rS.O~
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I (Ad.dresS) "3 '3 ~: '1 woo j {J \AC k
(Phone)
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A..PPLlCA."IT . f A ( "\
. 0!ilme)::A-;Vl ~L. ( ,t rc.., :r 0(;.. . (Phone) 9:;- c:l J 7'1" - S-cl Co
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; :,AddIess) ..Jl.::J-S" 3 )U ic 0 /1 ~ -f AtJL $0. /5 c.<..1' r'l ~ u: {I ~ 5"5 3 3 7
i (Ad.dre>>) (Ctty) (ZIp Coc.:)
i ,:Ccntil.ct Person) _ k' C<..\.( (Phone) (' q S-..L) 74 (., - s- ~ 0 0
,.'P?LlCANTSi ~NATURE -0 ~ DATE /~a9/oS-
APPLICANT PLEASE COMPLETE BELOW
i : - ONEW CONSTRUCTION 0 REPLACEMENT ~ AL TERA TIONS
fl:R.'lACEMA!i=:ANDMODEL R.e.-z.V\or u.r:1fi!P07~ FUEL
I
FLUE SIZE RETURN OPENINGS INPUT
TYPE OF SYS113M HEATING OR POWER PLANT
. OWarm Air Plmt3 0 Steam
. ~~::~i~1 ~o ~~~:
, Alr CondJtionin~ SpeciLl [)(vlce3
Vont Syctem Other Devices
..- J
OUTPUT
PLE..\SE NOn::
Air CondlLoner UnitS
Cwno~ EocrQa.cn into
Requl~ Side Yard
~cks
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i
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I Fl:li:PLACE M. K.E AND MODEL
FEE SCHEDlJLE
IDC~ltl':a.J. Comml ciaJ &. Multi-Family 1% of job 00,1 Resl(jenll~, GiJ Fireplace
S39.50 minimum
Kuidenllil. Hell:' ~ &. Ale (New Cormruction) S99.S0 Residential. Additionl ct Altorations
F.elidrn:lil, Heall g Only (New Construction) S6-UO ResldtntlaJ. AC Only
S39 58
53950
SJ 9 SO
~
~timated Cost S (~ 00.00
Buildin~ Permi! # ~5. / ~ " 7
.
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$
S
3 9, ~-<.)
.50
L/6.00
lome' Uu Only)
r-
i Thll AppUCll' ;00 Becomes Your BlIUdln~ ptrmlt When Approved
0503::33
Bulldi ,O(lldll
Dale
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fO.VV
Dat'io. z..f-, tJ5"'
24 hOllr Dolie. for 011 iuptetiolll (9~2) 447-98~O, ru (952) 447....H5