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24-Dobberpuhl
0� 5,4, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 1 ,`I /
AND UTILITY CONNECTION PERMIT / .. 1
4rNES0 I.
White rile PERMIT NO.
. /�1G/, (9e)3. Yellow Applicant
ase type or print and sign at bottom)
2Pink City
ADDRESS411
ZONING(office use)
17231 Horizon Trail SE., Prior Lake,MN 55372 ,
LEGAL DESCRIPTION(office use only)//���,,��� n �/ ,,,,,�� //� ,�,, Q(�
LOT '7 BLOCKZ ADDITION`�-44r'.�'J,C s Q a/' ✓ Z�� A4/0 PID �� I –O/3—O
OWNER
Bryan Dobberpuhl
(Name) (Phone) 952-484-9349
(Address) 17231 Horizon 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 ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
['Addition EAlteration ❑Utility Connection
CODE: ❑LR.C. ❑I.B.C. [xMisc. 1 Patio Door replacement& 1 Front Entry Door
Type of Construction: I II III IV V AB
•
cupancy Group A B E F H I M R S U PROJECT COST/VALUE $3,400.00
vision: 1 2 3 4 5 (exehrding land)
I hereby certify . I have—11i hed informatio. :- .is 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-mentione. property. d t .t all constr ctionwy 1 onform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revo -this p- it for ust cause. rthe . ,I hereby agree that the city o�i cut or a designee may enter upon the property to perform needed inspections.
X et rn..t_1-a.— I trYr v ACi.r1 j L¢_ / BC593158 12/28/2015
Signature Contractor's License No. BC593158 Date
Permit Valuation -2
6'0
69.-- Park Support Fee # $
Permit Fee $ 75.75 ''(4 7 c SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ i e.7 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 $ -7 s'"75-
This Applicati. :e omes Your Building Permit Wh,n App,.ved Paid /5 Receipt No.
/ifiK _____ 1 , r 4), Date / 9' (� By
'.uildmin . bate
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
en 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