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� C J �_ <br /> ; � � � <br /> " - • � Viereck Fireplace Sales Inc. � <br /> , � � : � , - <br /> � 16151 Ma.inAvenue S.E. • Prior Lake, MN 55372 �-- -� '' <br /> (612) 440-5620 / 440-5627 FAX � �� � �`S� <br /> Coniractor Safes C���l <br /> � �f�f a , nvoice # 3 618 <br /> CONTRA R' � PHONE �j AT <br /> 9�� `" / � / , �3 <br /> STREET JOB NAME �� <br /> CITY,STATE AND ZIP CODE LOCATION ��!� %�,,, I <br /> v �J�ti � <br /> INSPE TION: CUSTOMER TO CALL PERMIT#: SUPERI DENT/MOBILE#! # .�OB HONE <br /> YES : NO YES NO <br /> ' � Gas: Natural �� L.P. ❑ j � l c� <br /> Venting: Top � Rear ❑ � <br /> � ��� �� �- ���:�. . <br /> � S�ding <br /> Gas Fireplace Model: ✓J� <br /> 3 � � � <br /> � � �a �� <br /> Options: <br /> ��.� <br /> � <br /> � 3� <br /> 3 � <br /> Options: �1.� 6 <br /> DIRECTIONS: <br /> ��'�'` i <br /> V v <br /> � <br /> ITEMS NEEDED STARTUP: � LOCK BOX <br /> ' r <br /> . ��'�� <br /> ACCEPTANCE OF PROPOSAL The above prices,speafications and / <br /> conditions are satisfactory and are hereby accepted.You are authorized to do the �/,�Q� <br /> work as spedfied.Payment will be made as outlined above.Service charge 1.50° Si ature � <br /> on balance after 30 days. <br /> � � <br /> ►� /Y� _ Signatur� <br /> \N r <br /> Date of Acceptanc8: <br /> MODEL # SERIAL# INSTALL DATE <br />