HomeMy WebLinkAboutNo 11011 J ~
1s~4
~~f City of Lakeville
.HEATING PERMIT permit Fee
ReCel pt State Surcharge .50
TOTAL FEE PAID.. 3Q' ~t®
Permission is hereby granted to ~'r~x,i: ` ~sI'_" ~ `?~it~ " iX ``.or.,~ t. .
Building on Lot No. ~ Block r. Subdivision ''^n*lt~y~ Ve..11.~Y-zY-~xlf' $tl• Ar~*~t2
Parcel ~~~'?2-~"~1.77~-~3 k Plat
In the CITY OF LAKEVILLE to be used as L'L'*"~-1# ~„~r'~~ `'~°~~~i'1° r~~' C~ri~t~uctit~n
Thin permit is issued on the express condition that the ~~RECTION -~4LTERATION -REPAIRS
-ENLARGEMENT ~VIOVING DEMOLITION respects to the statements certified to in the application for
such permit, and that all work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State of Minnesota
pertaining to the construction of buildings.
Street Address ~~1~~{~- ~axsv''y ti°Jav ~1~':r[t Iaanf~a'Cd
Director, License and Inspection
1:
Attention is particularly called to the cutting up of streets, making main sewer `
connections, drivewaysand curbs. Obtain permitforsuch construction from the CITY j r'.. -~"f
OF LAKEVILLE. Inspection Department Not Responsible For Any Damages to Public By ` ~a
Utilities.
DATE:
CITY OF LAKEViLLE
BUILDING INSPECTION DEPARTMENT - (612) 469-4431
APPLICATION FOR HEATIN P
G ERMIT
Site Address : ~ ~ ~ ~ ~ ~
Alter _ Repair
Legal : Lot Block ~ Addition Install Replace
MAKE _ 1~`~ ~n ~ TYPE OP SYSTEM
SIZE l~ ~ Warm Air Plonts
CONN. LOtA`D ~ Gravity
FUEL ~ Mechanical
FLUE DIA. ~ ~ Air Conditioning
SUPPLY OPENINGS Vent System
RETURN OPENINGS Heating or Power Plant
INPUT _ ~ ~ ~ <7 Steam
OUTPUT Hot Water
EDR Radiation
CFM Wood-burning Stove:
Wood-burning Fireplace:
Plan No. ~ ~E' J`S ~ Date ~ ' 01 ~ ` ~ U
~ Est. Comp. Dote Est. Cost
I Heating Permit Fee ~
State Surcharge f
Total Permit Fees ~ C~
Owner's Name 1 ~ ~ ` ~C l7 Yl
Address ~ u ~c.~~
Heatin Contractor ~ ' r ~ r Tele hone ~DO`~J U c~
9 P
_ _
Address ~ ~ fYl~ 1 ~ City Zip ~ ~ U ~
Heating, Air Conditioning, Ventilation R Refrigeration Permit Fee for single family residence in-
stallation _.S$29.50 ~ ~,~Q~.urchargQ~------------------------------$
Alteration or Repair Min. Fee _ S ~~,SJS Q ~ ~ ~ Q _surcharge _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $
Non Residential Fee shall be computed at 1 % of the contract _ ~~524.50 + . 50 minimum)
Gas Piping Fee for each installation = Inc 11i~ed ..~hQV.~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $
Send application and heat loss calculation with check for Permits to:
CITY OF LAKEVILLE
Glenn A. (Barney) Langord Inspection Department Notice:
Plumbing & Heating Inspect. Box M
Call for ins
ection when
P
Lakeville, MCI 55044 work is completed.