2020-00292CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX (763) 295-4404
ADDRESS 4233 86TH ST NE
PIN 155252003030
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 003 BLOCK 003
PERMIT TYPE PLUMBING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NUMBER OF PLUMBING FIXTURES
APPLICANT
RICKS PLUMBING INC
1707 221ST AVE NW
CEDAR, MN 55011-
763) 753-1935
OWNER
NOVAK-FLECK
8857 ZEALAND AVE N
BROOKLYN PARK, MN 55443-
16
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
2020-00292*
DATE ISSUED: 04/10/2020
Permit #: 2020-00292
PLUMBING BASE FEE, RESI 50.00
PLUMBING FIXTURES 144.00
STATE SURCHARGE, PLBG FIX 1.00
TOTAL 195.00
Payment(s)
CHECK 17650 195.00
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Monticello
BUILDING SAFETY PERMIT # . L
505 WALNUT STREET, SUITE 1 MONTICELLO, MN 55362
CityHall (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: Z /B/ ZONED LEGAL:
Lot .5 Block _ Plat %'ems i ®Z,';,," 3; Property
Owner Name: No ' /e- Phone: Address:
City: State: Zip: Contractor
Name: State
License #: PL, V Address: ®
54-- Eng./
Architect Name: Address:
lumber
Name: Address:
Mechanical
Name: Address:
Tvne
of Work New
Addition
Alteration
Repair
Move
Other
Description
of work: I\
jCw Phone:..
E-
Mail: 01 AL, -a 4 -7 / J f Cs= -"-ICity:
0, t4 o State:
Zip:. 0 City:
City:
City:
Tvpe
of Construction A.
Single Family Duplex
Multi -
Family Commercial
Industrial
Other
Phone:
State:
Zip: Phone:
State:
Zip: Phone:
State:
Zip: Building
Information Use
of building of
stories Floor
area sq. ft. Estimated
value of
construction $ 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 AND
MECHANICAL INFO. Applicant
Signature Application Date t
l
APPLICANT.- Please show_ftxtures that are applicable.
Fire Suppression : (if applicable) Plumbine: (if applicable) Mechanical: (if applicable)
No. Fixture Tvne No. Fixture Tvue No. Fixture Tvpe
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
f Clothes Washer Bathrooms) Exhaust Fan
Fire Alarm: (if applicable) Water Heater Air Exchanger
Urinal Dryer
No. Fixture Tvoe Drinking Fountain Gas Opening w/o Fixture
P Floor Drain
of Devices Slop Sink
Other Outside Faucet
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: / /