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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
Date Rec' d
~. ~i~:n ~~~y I PERMIT NO. 7. I 0 2.31
1 Y cHow Applicant . .
ADDRESS
ZONING (office use)
54&0
'."l
Ifpo !- 6r
v(\w
)(e
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
C.Av AqeM.~
)/J C.~~\e(\,~(' J~
(Address)
.50
~ C\,
~~ ~
(Phone) 96~ .yO~ ~Jo
A~l tJ ~SdN
APPLICANT -;.) , , \
(Name) ) t'eL,S;CV\. \'''T~
3 "'0 a\1e*~
--c'.7'~<r'
(Contact Person) ~,
96J.. ~(p olK'7
1(( .AA.1 03~ 1&
(City) (Zip Code)
(Phone) 9;-cA .o6(Q 0/87
DATE /0.18 ,07
(Address)
LICANT PLEASE COMPLETE BELOW
DNEW CON RUCnON REPLACEMENT
FURNACE MAKE AND MODEL G~y~CM Kf.rUG.o~oc.. -) ~
FLUE SIZE ~ RETURN OPENINGS INPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
D AL TERA nONS
FUEL NAJ:
~COO OUTPUT $:000
DWarm Air Plants
o Gravity
~Mechanical
LlAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AIC (New Construction) $99.50
Residential, Heating Only (New Construction) ~ $64.50
Estimated Cost $ ~ ,31.1'1
Residential, Additions & Alterations
Residential, AC Only
$39.50
~
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
39 {fJ
_.. .50
"'16 -
$
$
$
(Office Use Only)
Buildin!! Official
Date
Paid 4-{). Du
Date J. ~ r- 7
O.C-' .l:
Rece' fNo. 64-64--7
B
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372