2019-00088CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS 4253 86TH ST NE
PIN 155246001090
LEGAL DESC FEATHERSTONE 3RD ADDITION
LOT 009 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE DECK
VALUATION : $ 3,500.00
NOTE: 12' X 12' DECK WITH STAIRS
APPLICANT
HANSON, BRUCE & LINDA
4253 86TH STREET NE
MONTICELLO, MN 55362-
OWNER
HANSON, BRUCE & LINDA
4253 86TH STREET NE
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
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2019-00088*
DATE ISSUED: 03/14/2019
Permit #: 2019-00088
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
Payment(s)
CREDIT CARD XXXX
103.09
1.75
104.84
104.84
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
I
CITY OF Permit No.
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BUILDING SAFETY Date
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RESIDENTIAL BUILDING PERMIT
ADDITION / ALTERATION / REMODEL
SITE ADDRESS
LEGAL DESCRIPTION
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LOT BLOCK PI.D. NUMBER
PLAT
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OWNER (Name) (Address) (Tel. No.)
CONTRACTOR (Name) (Address) (Tel. No.)
CONTRACTOR'S LICENSE NUMBER (IF APPLICABLE)
PLUMBING BEING COMPLETED BY (PLEASE CHECK ONE):
HOMEOWNER CONTRACTOR
IF APPLICABLE, SPECIFY CONTRACTOR Lic #
CHECK ALL THAT APPLY: TOILET SINK BAR SINK BATHTUB/SHOWER
LAUNDRY TUB SOFTENER OTHER
TOTAL # OF FIXTURES
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 CONTRACTOR
IF APPLICABLE, SPECIFY CONTRACTOR
CHECK ALL THAT APPLY: FURNACE A/C FIREPLACE BATHFAN
TOTAL # OF FIXTURES Bond #
DESCRIPTION OF WORK:(,. n
ESTIMATED VALUE OF CONSTRUCTION
31 3 5-0 1 . 00
Applicant Signature(
505 Walnut Street, Suite #1 Monticello, MN 55362
Approved by Building Official:
Date Approved: /off
Date
Phone: 763-295-3060 Fax: 763-295-4404
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