2021-00410CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS 102 KENNETH LN
PIN 155021002460
LEGAL DESC RITZE MANOR
LOT 046 BLOCK 002
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE WINDOW REPLACEMENT
NOTE: REPLACE 7 WINDOWS
APPLICANT
WINDOW GALAXY OF MN
19122 LOVE LAKE RD
BRAINERD, MN 5 640 1-
218) 821-0041
OWNER
QUIST, SUSIE
102 KENNETH 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 curb, sidewalk,
public utilities and signs will be repaired at my expense.
Applicant
Date
Bldg Official Date
Riffulmulm
2 0 2 1— 0 0 4 1 0*
DATE ISSUED: 05/28/2021
Permit #: 2021-00410
WINDOW FEE
STATE SURCHARGE, BLDG FIX
TOTAL
Payment(s)
CHECK 10018
100.00
1.00
101,00
101.00
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF V Ja I ( I - I Permit No.
Monticello
BUILDING SAFETY Date
RESIDENTIAL BUILDING PERMIT
ADDITION / ALTERATION / REMODEL
SITE ADDRESS
109) kenvie4b Lie
LEGAL DESCRIPTION
LOT
PLAT
OWNER (Name)
BLOCK PI.D. NUMBER
w D?\ k4anVXe-, bi A - 4 Ia - gz) a-3e Address) (
Tel. No.) N4"'
AbW 61a - - ) - () lb L4 CONTRACTOR (
Name) (Address) ' (Tel. No.) CONTRACTOR'
S LICENSE NUMBER (IF APPLICABLE) PLUMBING
BEING COMPLETED BY (PLEASE CHECK ONE): HOMEOWNER
CONTRACTOR IF
APPLICABLE, SPECIFY CONTRACTOR CHECK
ALL THAT APPLY: TOILET SINK BAR SINK LAUNDRY
TUB SOFTENER TOTAL #
OF FIXTURES Lic #
BATHTUB/
SHOWER OTHER
REMINDER:
IF YO U DO NOT OWN THIS PROPERTY OR ARE NOT PERFORMING THE WORK, PERMIT MUST BE PULLED BYA
MASTER PLUMBER) MECHANICAL
BEING COMPLETED BY (PLEASE CHECK ONE): HOMEOWNER
CONTRACTOR IF
APPLICABLE, SPECIFY CONTRACTOR CHECK
ALL THAT APPLY: FURNACE A/C FIREPLACE BATHFAN TOTAL #
OF FIXTURES Bond # DESCRIPTION
OF WORK: ESTIMATED
VALUE OF CONSTRUCTION Approved
by Building Official: f7
7 Date Approved: Applicant
Signatur - tl" C-10Awt- i d Date I 505
Walnut eet, Suite 01 Monticello, MN 55362 Phone: 763-295-3060 ddd
Fax:
763-2954404