2020-00810CITY OF MONTICELLO
505 WALNUT STREET * 2 0 2 0— 0 0 B 1 0*
MONTICELLO, MN 55362-
DATE ISSUED: 11/06/2020
763) 295-3060 FAX: (763) 295-4404
Permit #: 2020-00810
ADDRESS 4219 86TH ST NE
PIN 155252003020
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 002 BLOCK 003
PERMIT TYPE PLUMBING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NUMBER OF PLUMBING FIXTURES 16
APPLICANT PLUMBING BASE FEE, RESI 50.00
PLUMBING FIXTURES 144.00
RICKS PLUMBING INC
1707 221STAVE NW
STATE SURCHARGE, PLBG FIX 1.00
CEDAR, MN 55011- TOTAL 195.00
763) 753-1935 Payment(s)
CHECK 18072 195.00
OWNER
NOVAK-FLECK
8857 ZEALAND AVE N
BROOKLYN PARK, MN 55443-
AGREEMENT AND SWORN STATEMENT
1 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 //—S ` 2 c--
Bldg Official Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Monticello
BUILDING SAFETY PERMIT # (
7(-)— 1(')
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: 4219 86th st Ne
LEGAL: Lot Block
Property Owner Name: Novak Fleck
Address:
Contractor Name: Ricks Plumbing inc
State License #: PC642862
Address: 1701 221 st Ave NW
Eng./Architect Name:
Address:
Plumber Name: Ricks Plumbing
Address:
Mechanical Name:
Address:
Tvve of Work
El New
Addition
Alteration
Repair
Move
Other
Description of work:
New Home Plumbing
ZONED
Plat
Phone:
City: State: Zip:
Phone: 763-753-1935
E-]Mail: Rickplumbinginc@gmail.com
City, Cedar state: MN Zip: 55011
Phone:
City: State: Zip:
Phone:
City: State: Zip:
Phone:
City: State: Zip:
Tvne of Construction BuildinLj Information
El Single Family Use of building
Duplex of stories
Multi -Family Floor area sq. ft.
Commercial Estimated value
Industrial of construction $ 9500
Other
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.
10-12-20
Applicant Signa a Application Date
SEE BACK FOR PLUMBING
AND MECHANICAL INFO.
APPLICANT: Please show fixtures that are applicable.
Fire Suppression : (if applicable) Plumbine: (if applicable) Mechanical: (if applicable)
No. Fixture Tvae No. Fixture Tvne No. Fixture Tvue
Sprinkler Heads 3 Water Closet (toilet) Furnace
Other /Special FS Device 1 Bathtub Gas Meter
3 Lavatory (wash basin) Range Hood
2 Shower Gas Range
1 Kitchen Sink Water Heater
1 Dishwasher Air Conditioning
Laundry Tub Mech. Fireplace
1 Clothes Washer Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) 1 Water Heater Air Exchanger
Urinal Dryer
No. Fixture Tvae Drinking Fountain Gas Opening w/o Fixture
1 Floor Drain
of Devices Slop Sink
Other z Outside Faucet
16 TOTAL TOTAL
FOR CITY USE ONLY
Future Owner Information: Tree Ordinance Handout Yes No
Other Handouts Yes No
Name:
Address:
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: / /