2008-03117CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
295-3060 FAX: (763) 295-4404
ADDRESS 3657 REDFORD LN
PIN : 155151005110
LEGAL DESC GROVELAND 4TH ADDN
LOT 011 BLOCK 005
PERMIT TYPE BUILDING
PROPERTY TYPE : SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE : ROOFING
VALUATION : $ 8,700.00
NOTE: FINAL INSPECTION TO BE CALLED IN A MAXIMUM OF 48 HOURS AFTER COMPLETION
APPLICANT
SCHLEIF,BRYAN C & JENNIFER L
3657 REDFORD LN
MONTICELLO, MN 55362
OWNER
SCHLEIF,BRYAN C & JENNIFER L
3657 REDFORD LN
MONTICELLO, MN 55362
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 curl3 sidewalk,
public utilities and signs will be repaired at my expense
Applicant
Date
Bldg Official Date
munflunflfflum
2 0 0 8- 0 3 1 1 7*
DATE ISSUED: 10/02/2008
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
Payment(s)
CREDIT CARD 0510
177.29
4.35
181.64
181.64
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
MONTICELLO
MENEMMOMMOMEM
DEVELOPMENT SERVICES
BUILDING INSPECTIONS
505 WALNUT STREET, SUITE I
MONTICELLO, MN 55362
City Hall (763) 295-2711
LPID
MIT# / % #
Building Inspections (763) 295-3060 Fax (763) 295-4404
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: Jam? V*P'MD LN _ZONED
LEGAL: Lot Block Plat
Property Owner Name: I iFN gr JeVCO Phone: '
Address: '9657 'b= 1-1v City: fm GY-0- State: tWfV Zip:
Contractor Name: Phone:
State License #:
Address:
Eng./Architect Name:
Address:
Plumber Name:
Address:
Mechanical Name:
Address:
City:
City:
City:
City:
Phone:
Phone:
Phone:
State: Zip:
State: Zip:
State: Zip:
State: Zip:
Tvpe of Work Tyne of Construction Building Information
New 4 Single Family Use of building
Addition Duplex of stories
Alteration Multi -Family Floor area sq. ft.
Repair Commercial
Industrial
Estimated value
of construction $ _47Move
f Other i Residential Garage Is this a "Master Plan" per MN Rule
Other 1300.0160 Subp.6.9. Yes No
FOR ROOF & SIDING PERMITSDescriptionofwork:
50 PLEASE PROVIDE # OF5&VAVV6
SQUARES OF SHINGLES WOR
SIDING
I hereby apply for a permit for construction as described and acknowledge that the information I have provided above is complete and accurate. I
be in conformance with the ordinances of the City of Monticello and with the Laws of the State of Minnesota; agree that the work will conducted
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
I that any damage caused to public property including butbeinaccordancewiththeplanthathasbeenapprovedbytheBuildingOfficial. agree
not limited to curb. sidewalk, public utilities and signs will be repaired at my expense.
SEE BACK FOR PLUMBING
o/z/®g AND MECHANICAL INFO.
Appli nt Signakure Application Date
ial
I understand that the State of Minnesota requires thatallrasfor a
specific exemptionremodelers and
roofers obtain a state license unless they Y qualifyBy signingthisdocument, I attest to the fact that I am from thelicensingrequirements. from the state building or
improving this house myself. I hereby claim to be exemptrop y for purposes requirements because
I am not building or improving licensing quppforthis permit, of speculation
or resale and that the house for which aznirst m doh g structureI
have built located v
5; - .
I.
or improved
in the past 24 months. I also acknowledge than herwise have been entitled statee I
donothavealicense, I
forfeit any mechanic's lien rights to which may unde r
Minn. Stat. §514.01, In the event that I do construct or improve another residential structure in
the next 24 months, I will not do so d state elaw edate
icense, understanding that
failure to do so is a misdemeanor Furthermore, I
acknowledge that I may be hiring independent contractors to perform certain aspects
of the construction or improvement of b °the State of and I
understand Minnesota that
I
some
of
these contractors may be required to be licensed emodeling, and/or roofing activity is a understand that
unlicensed residential contracting,nsed misdemeanor under
Minn. Stat• §326.92, subd. 1. I also wh which canpay how owners contractors payintotheContractorsRecoveryFund, up to $
50,000 in the event their licensed contractor failsr c°mple
ent a work
from the
or performs
defective
work, but that I forfeit my rights Contractor's
Recovery Fund in the event that any contractors I hire are unlicensed. I also
acknowledge that as the contractor on this project, I am solely and personally responsible foranyviolationsoftheStateBuildingCodeand/or city ordinance in and thatIcanordinanceprosecuted
connection
with
the work performed on this property, s thatarenotcorrectedasordered by the City. criminally foranycodeviolation1SigriaturrAI3e4rt4yO-
w-
nerro 1®2
0 Date aired
to
be licensed, or to check To determine
whether a particular contractor is rel call the
Minnesota on the
licensing status of individual contractors, please De artmentofCommerce, Market Assurance Division, at (651) 296-2594, or toll- P freeat
1-800-657-3602.