HomeMy WebLinkAboutHEATING 06-1056
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONlNGH~u~EPLACE PERMIT
Date Rec'd
II. ZZ. 0"
(Please type or print and sil!11 at bottom)
ADDRESS
/i1L//~ WA-rL~j=L7(;ErI?AIL !tiE
1. Pmk
2. Green
3. Yellow
~. f PERMIT NO. /- 10.5 ~
A~~~ U7.
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 26: 11'1. OZ.I. ()
OWNER /7 .-
(Name) _K:;~~,::t.? :=2rE'/rUL/C
(Phone) ?@ /1'/;7,p/J8
(Address) ~1"4t::: ~ A&.'YvAC.
APPLICANT ?
(Name) \//L::,t-;qr?,t:. /'::;~7~t'-]FA~:3AL/;:;5
(Phone)
95;2 L/~kJ -:S-~..20
(Address) /l ,__ .
10/-'5/ /-fA/AI Hi//-: ~~ _.~V)f' IA~ ,5~d)?;;<
(Address) (City) (Zip Code)
(Contact Person) ",;:f; ~ ,IE ~ // (Phone) l'..'$c2 414t-::J.::}C:dc)
I APPLICANT SIGNATURE C_ ~ ';'~~.-::r ) _ DATE . t'~-;> N~~V ~
---- APPLICA.Nf PLE~E COMPLETE BELOW
[]NEW CONSlRUCTION 0 REPLACEMENT ~TERATIONS
FURNACE MAKE AND MODEL . FUEL
FLUE SIZE RETURN OPENINGS INPlIT OlITPlIT
lYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HA.jC:~T/C /W'ri'~b1
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ /. i/ 9.~. C2)
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Pennit #
$~ C;,~O
$ .50
$ L./.r) . cy')
,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildinl! Official
Date
Paid ./<J, 0 0
Date II. Z Z. . 0 ("
Receipt No. SZ(, 7 L
/J _
I By j1IiU-
24hournotire for aU". '"', ,_ :lUS(952) 447-9850, fn (952) 447-4245