2017-00880CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX- (763) 295-4404
ADDRESS 9091 GOLDEN POND LN
PIN : 155235003210
LEGAL DESC SUNSET PONDS 3RD ADDN
LOT 021 BLOCK 003
PERMIT TYPE MECHANICAL
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NUMBER OF MECHANICAL FIXTURES
APPLICANT
RECHER HVAC LLC
1125 MISSISSIPPI DRIVE
CHAMPLIN, MN 55316-
612)802-6525
Minnesota State License #: MB004223
OWNER
R HOME LLC
3495 COON RAPIDS BLVD
ANOKA, MN 55303-
8
AGREEMENT AND SWORN STATEMENT
I agree that the work will be conducted in conformance with
the ordinances of the City of Monticello and with the
Minnesota State Building Code. I understand that the work
will be in accordance with the plan that has been approved by
the Building Official. I agree that any damage caused to
public property including but not limited to curb, sidewalk,
public utilities and signs will be repaired at my expense.
Applicant
Date
Bldg Official Date
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2 0 1 7— 0 0 8 8 0*
DATE ISSUED: 11/29/2017
Permit #: 2017-00880
MECHANICAL BASE FEE, RESI 45.00
MECHANICAL FIXTURES 72.00
STATE SURCHARGE, MECH FIX 1.00
TOTAL 118.00
Payment(s)
CREDIT CARD 0207 118.00
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
ACITY
OF
t-,Montiello
BUILDING SAFETY PERMIT #
505 WALNUT STREET, SUITE 1 MONTICELLO, MN 55362
City Hall (763) 295-2711 Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: C16 v GoIJ LAB 110 ZONED LEGAL:
Lot Block Plat Property
Owner Name: Pc,ei&e_ Phone: Address:
City: State: Zip: Contractor
Name: 6 u,4(_ Phone: State
License #: Address:
City: State: Zip: Eng./
Architect Name: Phone: Address:
City: State: Zip: Plumber
Name: Phone: Address:
City: State: Zip: Mechanical
Name: Phone: Address:
City: State: Zip: Tvne
of Work Tvue of Construction Buildins Information J4
New k Single Family Use of building Addition
Duplex of stories Alteration
Multi -Family Floor area sq. ft. Repair
Commercial Estimated value Move
Industrial of construction $ Other
Other Description
of work: I
hereby apply for a permit for construction as described and acknowledge that the information I have provided above is complete and accurate. I agree
that the work will be conducted in conformance with the ordinances of the City of Monticello and with the Laws of the State of Minnesota; and
that I understand that this application is not a permit and that the work is not to start without a permit. 1 further understand that the work will be
in accordance with the plan that has been approved by the Building Official. I agree that any damage caused to public property including but not
limited to curb, sidewalk, public utilities and signs will be repaired at my expense. SEE
BACK FOR PLUMBING AND
MECHANICAL INFO. Applicant
Signata&' Application Date f
10,
APPLICANT: Please show fixtures that are applicable.
Fire Suanression : (if applicable) Plumbing: (if applicable) Mechanical. (if applicable)
No. Fixture Tvoe No. Fixture Tvae No. Fixture Tvue
Sprinkler Heads Water Closet (toilet) Furnace
Other/Special FSDevice Bathtub_ Gas Meter
Lavatory (wash basin) Range Hood
Shower Gas Range
Kitchen Sink Water Heater
Dishwasher_ Air Conditioning
Laundry Tub Mech. Fireplace
Clothes Washer Bathrooms) Exhaust Fan
Fire Alarm: (if applicable) Water Heater Air Exchanger
Urinal l Dryer
No. Fixture Tvne Drinking Fountain Gas Opening w/o Fixture
of Devices
Floor Drain
Slop Sink V_ Q.-is k ecd Qa.Spn'1 yb
Other Outside Faucet
Future Owner Information:
Name:
Address:
TOTAL TOTAL
FOR CITY USE ONLY
Tree Ordinance Handout Yes No
Other Handouts Yes No
City: ADDITIONAL INFORMATION:
State: Zip:
Valuation:
Construction Type:
Phone #:
Occupancy Group:
Division:
Square Footage:
of Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: Yes
Off -Street Parking Covered:
Off -Street Parking Covered
Building Official
BPT:
No
n