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<br /> *WOOD BURNING EQUIPMENT $15. 00 each unit - ��-�
<br /> Wood stove with flue
<br /> Wood conation or add-on unit
<br /> Factory fireplace with flue � {
<br /> Factor Fireplace (s ) freestanding Masonry ,<^
<br /> Wood Stove (s ) franklin, other ° _
<br /> Brand Name - Model No. `
<br /> Mfgr'sMin. , Clearances, side , rear , min. flue dia. , �
<br /> Total �'
<br /> ******************************************************************************** P
<br /> VENTILATION $15 . 00 each project
<br /> No. Kitchen Exhaust ducted recirculating cfm =w'
<br /> No. Bath Exhaust (must be ducted outside) cfm 'rp
<br /> No. Other Fans : Locations cfm
<br /> Total
<br /> ********************************************************************************
<br /> FUEL STORAGE (must be approved by fire marshal ) -._=-1=- -e----'77-------' " °
<br /> . X 30. 00 Permanent/Temporary . t a" a
<br /> wr Fuel oil, gallons_ underground inside outside ;` ;
<br /> x.i.
<br /> LP Gas, gallons
<br /> Other Gas opening ° ~
<br /> *** **************************************************************************
<br /> INE INSPECTION
<br /> =Low Pressure
<br /> $15 . 00
<br /> PERMIT FEE CALCULATION
<br /> 1. Total of above Installations or Minimum Fee ($30.00 ) $
<br /> 2. State Surcharge. Add the State Building Code Division ,
<br /> Surcharge to each permit
<br /> 3. Postage and Handling on all mailed-in applications , S 1 . 50 �t €. `
<br /> .,---4,5.,..4.--
<br /> 4 . TOTAL PERMIT FEE add lines 1-3 above $ k �� �A '4.
<br /> The undersigned hereby applies to the City of issuance of a Mechanical Permit,
<br /> agrees to do all work in strict accordance with the ordinances of the City and
<br /> the regulations of the Minnesota State Building Code, and certifies that all
<br /> statements made on this application are complete, true and correct.
<br /> Applicant' s Signature: Date:
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