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� ���.�1�i9�-----1`.c`I ----------THE ��IT''r' iF OROh;O 61--4��—�^.__,� '_�_,, <br /> t � <br /> *woa� BIIRN�NG � IIIPM�NT $��. 00 eacr� u��t <br /> Woad stove with flue <br /> Woad aomb�.nation or �dd-on ur�it <br /> �FaG�ory ��.re�lace with flu� <br /> Factor Fir�g�.�ce !�1 freestanc3inq � Masc�nr�► . <br /> Waod Stove (s � �rankl.Xn, other <br /> 8randName � Model No. <br /> Mfgr`s Min. , C�earance$r s�-d� _.....f r��r .�.....-..., min. f�u� dia. <br /> Tata�. <br /> �k*1�**ir*z�1c*!t**ttk**it*�ir*t#tk*it#��*ir�c*x**xse�e,krt***�t�kt**,t***,a***,t�r,k�**,t*x�*�t�*xt�**� <br /> VENTILATI4N $15.ab each Q�coj�c�G <br /> �{�.tCh�n Exhauat �uct�c3 zec� rculating ,�,,,� cfm <br /> NO. ctm <br /> �p� T— Bath Exhaus� imust be du���d au�side ) --� cfm <br /> �a, � Other Fans: Lo�ations Tota,� <br /> **�******x**�t*************�*r�****,rx*,r******�**�*�:,�x***rt���******r��***�***x«*� <br /> FU�L STORAG$ tmus� be �pprov�fl by �zre marsl�a�.? <br /> - • $30 . 00 Permanent,/Temporary ` <br /> Fue� oil, � g�lZons �� Uztderground R _ inside _ -- outside <br /> �� S+P Gas, gal,�ons <br /> �„ O�her �Noafi.�ru�N9 �r�N� „ �.L. Gar� v�ening <br /> *****�**,t*��rc***�r,�***,t*"�*r�*****��r********�,��*�*******�*�:**�******,�**********�r <br /> r�s Lz� Yt�s�Bc�rzaz� �15 . o 0 <br /> H�.gh/T,aw Pressure <br /> **�r**�r**�t**�****�t�*****�t***�***,r*�k**v�,�****�****�*�c**��rr,��c*****�r�x********,�***� <br /> pgRMx� gEE GALCt7�.ATZ ON <br /> 1. Tota� of abc�ve Ins�allations or I�i:ni.�um �ee ($30.OD ) $ ��� <br /> 2. Stat� ,Surehar e. Add the State Builda.ng Cade Divi.sion � . 50 <br /> 5urcharge to each permit � �._ <br /> 3. Pasta e and Handlin on all maileu�-in apQl�cations , <br /> 4, TOTAL PERMZT. FEE add lines 1-3 above $ �� 0 _ <br /> Th� under�igned �h work in s tri ct�accc�rdance w�h the nordi.nances� of the zC �y , <br /> agrees �c� do a <br /> �he r�gulations of the Minnesata State gUild�ng CQde, and certifi�s �hat� <br /> sta�ements made an tha.s �pp�.ication are c�mglete, tru� and �orrect• <br /> Da�e: �> l l0 ��Z <br /> Applicant' s Signature: . <br /> , <br />