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23-Glover Date Recd
04A 0,, CITY OF PRIOR LAKE BUILDING PERMIT, �.�
A- e TEMPORARY CERTIFICATE OF ZONING CO TPLIANCE '� . I(��` '
—6'-' N,t
AND UTILITY CONNECTION PERMIT
I
jNNEs° I. White File PERMIT NO. 5
2. Pink City
3 Yellow Applicant
ZONING(office use)
ease .e or t rint and si 1, at bottom)
• DRESS
17247 Horizon Trail SE.,Prior Lake,MN 55372
LEGAL DESCRIPTION(office use only) /�!�
_ 11l
'
LOT BLOCK ADDITION PID
Olc•
'• , Jeff Glover (Phone) 952-221-3288_-_
(Name) 17247 Horizon Trail SE.,Prior Lake
Address
BUILDER 8
-202
(Company Name) PCS Residential (Phone) 651(Phone) 651-99494 202618
(Contact Name) Pam Pomerenke
(Address) 2005 Pin Oak Drive Easan MN 55122
DRe-Siding OLower Level Finish ❑Fireplace
TYPE OF WORK ❑New Construction DDeck ['Porch6-Re-Roofing
❑Addition DAlteration ['Utility Connection
0 Misc: 25 SQ Shin:les remove and re slace
CODE: DI.R.C. DI.B.C. I II � IV V A B 10,534.75
Type of Construction: I MR SU PROJECT COST/VALUE $
occupancy Group: A B E F H 4 5
t ivision: 1 2 3
to performbmneeded.. I inspections.
t ill application
to whichl is to stateheand local laws and will proceed in accordancealso
with that I amd plans. I am aware that the tfor buildinge
I hereby certify that I have furnished information on this application is to the best of my knowledge true and correct. I also certify I the owner or authorized agent ort e
c
o
al
exi
above-mentionedcialcrevoke prone • and that all cons � ,-t ore,I hereby agree that the city official or a designee may enter upon the property
official can t��� it fro just A �� �-.�V 12/9/2015
Lg 1 BC593158 BC593158 Date
R Contractor's License No.
Signature
Park Support Fee #
Permit Valuation 1111.11111111111 ljIIIIIIIINII
UIINIIIIIIII
Permit Fee Water Meter Size 5/8"; 1";
1111111111111
Plan Check Fee ligli Pressure Reducer 111111111111111
V
EMINVE Sewer/Water Connection Fee #
Penalty 1111111111111111
Water Tower Fee #
Plumbing Permit Fee 11111111111111 1111111111111111
Builder's Deposit
Mechanical Permit Fee IIIIIMIIIIIIII 111111111111111
Other
Sewer&Water Permit Fee 1111111111111111
TOTAL DUE
Gas Fireplace Permit Fee
Recei.t No. -10/0111111This Application Becomes Your Building Permit When Approved Paid ingnalliallDate B
Buildin•Official
Date
application and accompanying a e Certificate of Occupancy must nt
T
in documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when
is signedto certify that the Planneraris the constitutes
compliance and allows construction to commence. Before occupancy,
be
when by the City constitutes a temporary Certificate of Zoning
.sued.
Special Conditions,if any
Date
Planning Director
24 hourtice for all inspections Dakota Street S.E. Prior Lake,Minnesota9 55372 447-4424.
4646