2021-00305CITY OF MONTICELLO
505 WALNUT STREET * 2 0 2 1- 0 0 3 0 5*
DATE ISSUED: 04/22/2021
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
Permit #: 2021-00305
ADDRESS 8818 FARMSTEAD AVE
PIN 155259001070
LEGAL DESC HAVEN RIDGE
LOT 007 BLOCK 001
PERMIT TYPE MECHANICAL
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE FIREPLACE
NUMBER OF MECHANICAL FIXTURES 1
APPLICANT MECHANICAL BASE FEE, RESI 50.00
MECHANICAL FIXTURES 9.00
HAGEN FIREPLACE SOLUTIONS
STATE SURCHARGE, MECH FIX 1.00
435 FAIRVIEW AVE
2 TOTAL 60.00
ST PAUL, MN 55104- Payment(s)
612) 839-7595 CHECK 3642 60.00
OWNER
HAVEN RIDGE LLC
1313 HILLWIND RD
FRIDLEY, MN 55432-
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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Monticello
BUILDING SAFETY PERMIT #40M_005
505 WALNUT STREET, SUITE 1 MONTICELLO, MN 55362
City Hall (763) 295-271 l Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: 'S r r-r-, 5 T-CA o A V & ZONED
LEGAL: Lot Block Plat
Property Owner Name: (!A Phone:
Address: City: State: Zip:
Contractor Name: HAGEN FIREPLACE SOLUTIONS Phone:
State License #: MB680260 E-Mail:TYLER.SCHULTZ@FERGUSON.COM
Address: 710 TANGLEWOOD DR City: SHOREVIEW State: MN Zip: 55126
Eng./Architect Name:
Address:
Plumber Name:
Address:
Mechanical Name:
Address:
Tvve of Work
a New
Addition
Alteration
Repair
Move
Other
City:
City:
City:
Tv -De of Construction
E9, Single Family
Duplex
E] Multi -Family
Commercial
Industrial
Other
Description of work:
SET AND VENT 1 GAS FIREPLACE GAS LINE BY OTHERS
Phone:
State:
Phone:
State:
Phone:
State:
Building Information
Use of building
of stories
Floor area sq. ft.
Estimated value
of construction $
Zip:
Zip:
Zip:
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. I 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
I AND MECHANICAL INFO.(
Applicant Signature Application'Date v
APPLICANT. Please show fixtures that are applicable.
Fire Suooression : (if applicable) Plumbine: (if applicable) Mechanical: (if applicable)
No. Fixture Tvve No. Fixture Tvpe No. Fixture Tvve
Sprinkler Heads Water Closet (toilet) Furnace
Other/Special FS Device Bathtub Gas Meter
Lavatory (wash basin) Range Hood
Shower Gas Range
Kitchen Sink Water Heater
Dishwasher Air Conditioning
Laundry Tub Mech. Fireplace
Clothes Washer Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) Water Heater Air Exchanger
Urinal Dryer
No. Fixture Tvve Drinking Fountain Gas Opening w/o Fixture
Floor Drain
ofDevices Slop Sink
Other Outside Faucet
TOTAL TOTAL
Future Owner Information:
Name:
Address:
FOR CITY USE ONLY
Tree Ordinance Handout Yes No
Other Handouts Yes No
City: ADDITIONAL INFORMATION:
Valuation:
State: Zip: Construction Type:
Occupancy Group:
Phone #: Division:
Square Footage:
of Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: Yes No
Off -Street Parking Covered:
Off -Street Parking Uncovered:
Building Official
BPT: / /