2022-00037CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX (763) 295-4404
ADDRESS 4416 86TH ST NE
PIN 155264002080
LEGAL DESC EDMONSON RIDGE
LOT 008 BLOCK 002
PERMIT TYPE MECHANICAL
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE FIREPLACE
NOTE: INSTILLATION OF ANEW DIRECT VENT GAS FIREPLACE
NUMBER OF MECHANICAL FIXTURES 1
APPLICANT
METRO HOME
5861 QUEENS AVE NE
ELK RIVER, MN 55330-
763) 428-8115
OWNER
LSW INVESTMENTS LLC
4065 CHELSEA RD W
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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2022-00037*
DATE ISSUED: 02/10/2022
Permit #: 2022-00037
MECHANICAL BASE FEE, RESI 50.00
MECHANICAL FIXTURES 9.00
STATE SURCHARGE, MECH FIX 1.00
TOTAL 60.00
Payment(s)
CREDIT CARD 4502 60.00
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
1rl MopticeHo n
t -
PERMIT N2O,` Q0 7
S115 WALNU I STRI-H. St I I l- I MONTI('F.LLU. MN 55362
City Hall (763) 295-271 1 Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: 4416 86th SINE
1.1 0AL. Lot Bloch Plat
Property Owner Name: JP Brooks
ddress:
Contractor Name: Metro Home Insulation
State License #: BC598505
Address. 5861 Queens Ave NE
Eng.iArchitect Name:
Address:
Plumber Name:
lddress.
Mechanical Name:
Address.
Tvve of Work
N e %%
lddilmi
Alteration
Repair
Movc
Other
City:
Phone:
ZONED
State: Zip:
Phone: 6128066149
F-Mail:david.gardner@installed.net
ity: Elk River Stale: MN Zip: 55330
Phone:
City. ---- -- State:___ Zip. - --
Phone: _
City: _ -- - State —_— zip:
Phone:
City: State: Zip:
Tvne of Construction
Single Family
O Duplex
O Multi-hatnily
Commercial
Industrial
Other
Description of work:
Set and Vent Gas Fireplace-GAS/ELECTRIC installed by others
Building Information
Use ot'building Residential
ol'stories
Floor area ails n. - -- -
Estimated value
ol'construction
I t,cich% applv for a permit for construction as described and acknowledge that the infitirmation I have provided above is complete and accurate. 1
lglee that the wort, will he umducted in contormame with the ordinances of the city of Monticello and with the Laws of the State of Minnesota:
mil that I underswnd that this application is not a pumm and that the work is not to start without a permit I further understand that the work will
he in accordancc with the plan that has been approccd by the Building t t1icial I agree that anv damage caused ai public property including but
uoi hmrtcd to curb. sidc%%alk, publik. utilities and Signs Kill lit' repaucti at 1110C\pC11Se i
40oo SEE
BACK FOR PLUMBING 1/
25/2022 AND MECHANICAL INFO. Application
Date
APPLICANT: Please shom_rt+t*res that are anplic•able.
Fire Suppression : (il'applicable) PlumbMe: (if applicable) ifec•hanical: (if applicable)
No. Fixture I'voe No. Fixture I voe No. Fixture Tvne
Sprinkler llead Hater Clo.mi (toilet) Furnace
Other 'Special FS Device Bathtub Gas A7eter
Lavalmy (flash basin) Range Hood
Shower Gas Range
Kitt -lien Sink Water Heater
Dishwasher Air Conditioning
Laundty Tub Afech. Fireplace
Clothes If usher Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) I•titer Heater Air E.cc hanger
l Irinal Dryer
No. Fixture TVne Drinking Fountain Gas Opening a/o Fixture
Floor Drain
of Devices Slop Sink
Other Outside /aucer
TOTAL TOTAL
I Future Owner Information:
i
I'vame•
jiAddress.-- Ulty.
State -
I
Phone
r FOR
CITY USE ONLY Tree
Ordinance Handout Other
Handouts Yes
1
es ADDITIONAL
INFORMATION: No
No
Valuation:
Zip: _ ('
unSWIM iuu Type: - ---- Occupancy Group: --
Division: a_--- -
Squaw
Footage.
4 of
Stones: 4 of
Itesidentuil l InItS. - - - - - - Maximum Occupancy:
Fire Sprinklers:
O Yes O No Off -Street
Parking Covered: Off -Street
Parking Uncovered: BuildinR Official/—
BPT: I