2022-00133CITY OF MONTICELLO
505 WALNUT STREET * 2 0 2 2— 0 0 1 3 3*
DATE ISSUED: 03/18/2022
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
Permit #: 2022-00133
ADDRESS 4426 86TH ST NE
PIN 155264002090
LEGAL DESC EDMONSON RIDGE
LOT 009 BLOCK 002
PERMIT TYPE PLUMBING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NUMBER OF PLUMBING FIXTURES 13
APPLICANT PLUMBING BASE FEE, RESI 50.00
PLUMBING FIXTURES 117.00
S & S PLUMBING INC
STATE SURCHARGE, PLBG FIX 1.00
18738 93RD STREET
BECKER, MN 55308- TOTAL 168.00
763) 263-5599 Payment(s)
CREDIT CARD 168.00
OWNER
JP BROOKS
11314 86TH AVE
MAPLE GROVE, MN 55369-
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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Monticello
BUILDING SAFETY PERMIT # ; - p — D
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: 4,- i, - / ZONED
LEGAL: Lot Block Plat
Property Owner Name: ,. , Phone:
Address: City: w State: On 4/ Zip:
Contractor Name: 51:4- S Phone:
State License #: PC 4. % e/ E-mail:
Address: ''3 , City: / State: / Zip: ,s
Eng./Architect Name:
Address: City:
Plumber Name: 5
Address: /Sr7-3 City:J /
Mechanical Name:
Address: City:
Twe of Work
INew
Addition
Alteration
Repair
Move
Other
Description of work:
TVDe of Construction
1T Single Family
p Duplex
Multi -Family
Commercial
Cl Industrial
Other
Phone:
State: Zip:
Phone:
State: 41)ib Zip: Sj'cok
Phone:
State: Zip:
Buildinu 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.
Applicant Sigira-ture
SEE BACK FOR PLUMBING
AND MECHANICAL INFO.
Application Date
v
APPLICANT: Please show fixtures that are applicable.
Fire Suppression : (if applicable) Plumbink: (if applicable) Mechanical: (if applicable)
No. Fixture Tvve No. Fixture Tvae No. Fixture Tvoe
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
l Dishwasher Air Conditioning
Laundry Tub Mech. FireplaceL
Clothes Washer Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) Water Heater Air Exchanger
Urinal Dryer
No. Fixture Tvpe Drinking Fountain Gas Opening w/o Fixture
Floor Drain
of Devices Slop Sink
Other Outside Faucet
Name:
Address:
City:
State:
Phone #:
TOTAL
Future Owner Information:
TOTAL
FOR CITY USE ONLY
Tree Ordinance Handout Yes No
Other Handouts Yes No
ADDITIONAL INFORMATION:
Valuation:
Zip: Construction Type:
Occupancy Group:
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: