HomeMy WebLinkAboutMechanical Permit 13. 1065 N 0 Q F-
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o f YRI0� CITY OF PRIOR LAKE Date Rec'd
HEATING /AIR CONDITIONING/FIREPLACE PERMIT
rii 6 . E .... /3 (— 1(03 /'
�I �P 1. Pink File PERMIT N O.
NNESO 2. Green City
3. Yellow Applicant / - -/�
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
1 9 PAAX. )Cum 4)/.:
LEGAL DESCRIPTION (office use only) 454* 001*
LOT BLOCK ADDITION PID 0U = —
OWNER 1 v r i ,
(Name) #414 4 4 _ , _ . i—_ .1— , . 1 . (Phone)
(Address)
APPLICANT/"` ) l pU t 7
(Name) ( O, f V ) 1� J / /40 /1/ ( Phone ) ( ( 4 0 - S9W
(Address) „16. V AiV
(Contact Person u ` (Phone) a : ,
APPLICANT SIGN • i � -s „b 'W - , f r DATE 1 O 9 1
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APP CANT PLEASE COMPLETE BELOW
NEW CONSTRUCTION ❑REPLACEMENT ALTERATIONS
FURN E MAKE AND MODEL N A FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner
arm. Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
El Gravity El Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
El Air Conditioning ❑ Special Devices Cantilevers to the Outside of Buildings
❑ Vent. System ❑ Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions &Alterations $49.50
Residential, Heating Only (New Construction) $64.50 ao Residential, AC Only $49.50
Cost $ 300 0 Building Permit#
HEATING PERMIT FEE $X1
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ Sti /AL
This Applicatii i B omes Your Building Perm' Wh : Approved Paid S Receipt No Qd 0
fii 0 . Date �Q/�/j Z By ��
Buildi 1 1 ate N .rr�C.��
24 hour notice for all inspections (952) 447 -9850
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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