HomeMy WebLinkAboutMech Permit 02-1583
--~.::... .... r-'"'J.V-K LAKE
I4J 001
CITY OF PRIOR LAKE
HEATING/AlR CONDITIONINGfFlREPLACE PERMIT
Date Rec'd
~: ~I;'~n ~!~. .! PERMIT NO.;/} "),.. .ILCI~
), Y.II_ Appll<.n, (/V'),:J 0 '\J
(please tYoe or Pr'..nt and si!1;!l at bottom)
ADDRESS
,~(')(~ t ~~
() I;lC.)j :/J /' '
ZONING (office use)
PtAO
LEGAL DESCRIPTION (office USe only), d
LOT/3BLOCK ,I ADDlnoNWd~ ,~y
PIDOSS- ::33 ?-O/3-()
OWNER
(Name) _'/R .4:./--7 / ~
~rY?~
(Phone) QQ5-' '5q~o,
(Address)
APPLICANT II D
(Name) 'CD/l.2f./'du J
Qf/'
(Phone) 4Cd!J
(AddTC::SS)~ /;::;) /r)
eQ.~~ ,4ue.
(.~ddress )
Po.. h J
a
.m/fJ
(City) /
Go:;);!;)
:~ ;:;',:;14
(Zill Code)
o
APPLICANT SIGNATURE ~'.c.h'
(Contact Person)
:k~
(Phone)
DATE
../,-0 - 9 - 0 ::;)
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTXON 0 REPLACE
FURNACE MAKE AND MODEL
FLUE SIZE RETURN OPE
TYPE OF SYSTEM
CLOSED WITH LL PERMIT #02-
1601
LEASE NOTE:
ir Conditioner Units
annotEncroach into
Requir~d Side Yard
Setbacks
OWa.-m Air Plants
o Graviry
o Mechanical
OAir Conditioning
OVen!. System
FIREPLACE MAKE A!'i'D MODEL ~ f A,)
U ~peClal LlevlC:C~
o .Othcr Devices
t:,/n
~L - 751-)
FEE SC.HEDULE
Tndustria.l. Commercial & Multi-Family 1% of job <;o~t Residential, Gas Fireplace
$39.50 minimum
Residential, Heating &. J.JC (New Construction) . S99.50 Res\dential, .....dditions & A.lterations
ResidentiaL Heating Only (New Construction) $64,50 Residential, AC Only
539.50
S39.50
$3950
Estimated Cost S
Buiiding Permit '#
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~q,sC)
.50
.-JI 0 _ (") ()
(orne, US~ Only)
Tbis Al:Plic.:ation Becomes Your Building permit When Approved
Building Official
Date
Paid!/) L(tJ. ----- I Rece~~p C; g;
Date ()........ --+ By ~....o ./
I.:J _1/ - 0 I 'lfL---'
v
24 hour notice for all inspedibns (95?) 447-9850, fax (.952) 447-4245