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.0pRIO 1013873-
/ Herbst CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Recd
AND UTILITY CONNECTION PERMIT /" /1 ,iç—
ki E S°�'s"
I. White File NO.I PERMIT
2, Pink City `
lease type or print and sign at bottom) 7
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7128 orizon Trail SE., Prior Lake,MN 55372 3. Yellow Applicant
ZONING(office use)//vJ /
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID 05—ALI• O47 0
OWNER Phil &Julie Herbst
(Name) r�/�� (Phone) 612-363-1843-Cell
(Address)
iiiorizon Trail SE.,Prior Lake
BUILDER
(Company Name) PCS Residential (Phone) 651-994-2028
(Contact Name) Pam Pomerenke (Phone) 651-255-0618
(Address) 2005 Pin Oak Drive, Eagan, MN 55122
TYPE OF WORK ❑New Construction ['Deck ['Porch
❑Alteration ❑Re-Roofing ❑Re-Siding ['Lower Level Finish El Fireplace
['Addition ❑Utility Connection
iioCODE: ❑I.R.C. ❑I.B.C. ®Misc: 13 Full Window Replacements
Type of Construction: I II III IV V A B
ccupancy Group: A B E F H I M R SU PROJECT COST/VALUE $ 34,170.99
ivision: 1 2 3 4 5 (excluding land)
I hereby certify that -.ve furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-mentioned•op and that all constru• will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can riga ',permit for just Cady ermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X a " 4AJ)4._j BC593158 9/3/2015
Signature
Contractor's License No. Date
Permit Valuation Park Support Fee #
Permit Fee $ 4.75 SAC
Plan Check Fee $ Water Meter Size 5/8"; 1";
State Surcharge $ J (3 Pressure Reducer
!' $
Penalty $ Sewer/Water Connection Fee #
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
$
Sewer&Water Permit Fee $ Other
$
Gas Fireplace Permit Fee $ TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid ''.7S7 7 c---� Receipt No. 2.82-5
Date 9_ it. 1 S By -
i
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
hen signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
ed.
Planning Director Date
Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372