2020-00633CITY OF MONTICELLO IIIIIIIIIIII11111111111111111111111111111111111111111111111
505 WALNUT STREET * 2 0 2 0- 0 0 6 3 3*
DATE ISSUED: 08/12/2020
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
Permit #: 2020-00633
ADDRESS 8522 EBERSOLE AVE
PIN 155246004030
LEGAL DESC FEATHERSTONE 3RD ADDN
LOT 003 BLOCK 004
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE BASEMENT FINISH
VALUATION 14,512.00
NOTE: BASEMENT FINISH: ONE BEDROOM, ONE BATHROOM, ONE FAMILY ROOM WITH A WET BAR AREA
APPLICANT
HERBST,JOSEPH
8522 EBERSOLE AVE
MONTICELLO, MN 55362-
OWNER
HERBST,JOSEPH
8522 EBERSOLE AVE
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
BUILDING PERMIT FEE 266.33
PLAN REVIEW 173.11
STATE SURCHARGE, BLDG VAL 7.26
TOTAL 446.70
Payment(s)
CREDIT CARD XXXX 446.70
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Montf6effo
BUILDING SAFETY
Permit No. " Lc n5
Date 7- ems-2®
RESIDENTIAL BUILDING PERMIT
ADDITION / ALTERATION / REMODEL
SITE ADDRESS8522 Ebersole Ave
LEGAL DESCRIPTION
LOT BLOCK
PLAT
OWNER (Name)
Joseph Herbst
CONTRACTOR (Name)
Monticello MN 55362
CONTRACTOR'S LICENSE NUMBER (IF APPLICABLE)
PI.D. NUMBER
Address)
8522 Ebersole Ave NE
Address)
Tel. No.)
6127907754
Tel. No.)
PLUMBING BEING COMPLETED BY (PLEASE CHECK ONE):
HOMEOWNER X CONTRACTOR
IF APPLICABLE, SPECIFY CONTRACTOR Lic #
CHECK ALL THAT APPLY: X TOILET X SINK X BAR SINK X BATHTUB/SHOWER
X LAUNDRY TUB SOFTENER OTHER
TOTAL # OF FIXTURES 5
REMINDER: IF YOU DO NOT OWN THIS PROPERTY OR ARE NOT PERFORMING THE WORK, PERMIT MUST BE PULLED
BY A MASTER PL UMBER.)
MECHANICAL BEING COMPLETED BY (PLEASE CHECK ONE):
HOMEOWNER X CONTRACTOR
IF APPLICABLE, SPECIFY CONTRACTOR
CHECK ALL THAT APPLY: FURNACE A/C FIREPLACE X BATHFAN
TOTAL # OF FIXTURES 1 Bond #
DESCRIPTION OF WORK:
Finishing basement including the addition of a bathroom, wet bar, and bedroom.
ESTIMATED VALUE OF CONSTRUCTION
Approved by Building Official:
Date Approved: 7 /Z 9
Applicant Signature % r% Date
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50 Watn Street, ite 01 Monticello, MN 55362 Phone: 763-295-3060 Fax: 763-2954404
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PHONE:763-295-2711 FAx:763-295-4404
505 Walnut Street Suite 1 Monticello, MN 55362
I understand that the State of Minnesota requires that all residential building contractors,
remodelers and roofers obtain a state license unless they qualify for specific exemption from
the licensing requirements. By signing this document, I attest to the fact that I am building or
improving the house myself. I hereby claim to be exempt from the state licensing requirements
because I am not building or improving property for the purpose of speculation or resale and
that the house which I am applying for this permit located at: aSU C6*4%rw6 A-JC- )JG
is the first residential structure that I have built or improved in the last 24 months. 1 also
acknowledge that because I do not have a state contractor's license, I forfeit any mechanic`s
lien rights to which I may otherwise have been entitled under Minn, Stat. 514.01. In the even
that I do construct or improve another residential structure in the next 24 months, I will not do
so until I obtain the required state license understanding that failure to do so is a misdemeanor
under state law.
Furthermore, I acknowledge that I may be hiring independent contractors to perform certain
aspects of the construction or improvement of this house and I understand that some of these
contractors may be required to be licensed by the State of Minnesota. I understand that
unlicensed residential contracting, remodeling, and / or roofing activity is a misdemeanor under
Minn Stat. 326.92, subd. 1. 1 also acknowledge that all licensed contractor's pay into the
Contractor's Recovery Fund, which can pay homeowners up to $50,000 in the event that their
licensed contractor fails to complete worts or preforms defective work, but that I forfeit my
rights to reimbursement from the 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
for and violations of the State Building Code and / or City Code in connection with the work
performed on this property, and that I can be prosecuted criminally for any code violations
that are not corrected as ordered by the City.
gnature of Property Owner date
To determine whether a particular contractor is required to be licensed, please call the
Department of Labor and Industry @ 651-284-5012