2026-00232CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 P'AYU (763) 295-4404
ADDRESS 4458 86TH ST NE
PIN 155264002120
LEGAL DESC EDMONSON RIDGE
LOT 012 BLOCK 002
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE BASEMENT FINISH
VALUATION 30,000.00
NOTE: LOOK AT STAMPED COPY OF BUILDING PLANS FOR ANY NOTES/RED STAMPS
SEPARATE PERMIT REQUIRED FOR ELECTRICAL WORK.
ELECTRICAL ROUGH IN INSPECTION TO BE DONE BEFORE FRAMING INSPECTION
ADDING 2 BEDROOMS, 3/4 BATH, LIVING ROOM AND FLEX/EXERCISE ROOM
2 0 2 6— 0 0 2 3 2
DATE ISSUED: 04/10/2026
Permit #: 2026-00232
APPLICANT BUILDING PERMIT FEE 468.28
PLAN REVIEW 304.38
JOHNSON, CHAD & CASSIDY
STATE SURCHARGE, BLDG VAL 15.00
4458 86TH STREET NE
TOTAL 787.66MONTICELLO, MN 55362-
Payment(s)
CREDIT CARD 7647 787.66
OWNER
JOHNSON, CHAD & CASSIDY
4458 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 a ins will be repaired at my expense.
Applicant >z/L
Dater =2 d
Bldg Official Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Montice nD CoF.E VIE
BUILDING SAFETY
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ADD
Permit No.
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SITE ADDRESS
4458 86th St NE Monticello MN, 55362
LEGAL DESCRW`iO
LOT BLOCK PI_D. NUMBER
PLAT
OWNER'S NAME (Address) (Email Address) (Tel_ No.)
Chad Johnson 4458 86th St NE U 1v S/1._fGNDk,con 320-221-0620
CONTRACTOR (Address) (Contact) (Tel. No.)
CONTRACTOR-S LICENSE NUMBER (IF APPLICABLE) (Applicant Email)
PLUMBING BEING COMPLETED BY (PLEASE CHECK ONE):
IUONVINER C :RMC U(69k
IF APPLICABLE, SPECIFY CONTRACTOR Lic #
M_ El [14CHECKALLTHATAPPLY: TOILET IN SINK BAR SINK BATHTUB/SHOWER
QI.Ai CRY TZ4 % 13 '1ZERSOFT
TOTAL # OF FIXTURES 3
REMINDER: IF YOUDO NOT OWN THIS PROPERTY OR ARE NOT PERFORMING THE WORK, PERMIT MUST BE PULLED
BY A MASTER PLUMBER.)
ME+C`RANICAJ, EEI.NG f_'0- MPLETED BY (PIXASE_ CRUX ONE,)-.
HOMEOWNER CONTRACTOR
IF APPLICABLE, SPECIFY
CONTRACTOR
CHECK ALL THAT APPLY:11 FURNACE E]A/C DFIREPLACE B BATH
TOTAL. 4 OF FUCFURES
DESCRIPTION OF WORK:
Adding 2 bedrooms, 3/4 bath, living room, and flex/exercise room.
ESTIMATED VALUE OF CONSTRUCTION
Approved by Building Official:
Total Due
30,000
Date Approved: L"0;k9"
APPLICANT SIGNATURE Date G-
505 Walnut St, Suite #1 Monticel o, MN 55362 763-295-3060 Email: buildingdepartment*,,ci.monticello.mn.us
CITY OF
MVont1k1--1.,,e o
BUILDING SAFETY
BUILDING PERMIT APPLICANT: PROPERTY OWNER
I understand that the State of Minnesota requires that all residential building contractors,
remodelers and roofers obtain a state license unless they qualify for specific exemption from
the licensing requirements. By signing this document, I attest to the fact that I am building or
improving the house myself. I hereby claim to be exempt from the state licensing requirements
because I am not building or improving property for the purpose of speculation or resale and
that the house which I am applying for this permit located at: i '15 S, 'V.4 5 t A L, ,
is the first residential structure that I have built or improved in the last 24 months. I also
acknowledge that because I do not have a state contractor's license, I forfeit any mechanic's
lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. In the even
that I do construct or improve another residential structure in the next 24 months, I will not do
so until I obtain the required state license understanding that failure to do so is a misdemeanor
under state law.
Furthermore, I acknowledge that I may be hiring independent contractors to perform certain
aspects of the construction or improvement of this house and I understand that some of these
contractors may be required to be licensed by the State of Minnesota. I understand that
unlicensed residential contracting, remodeling, and / or roofing activity is a misdemeanor under
Minn Stat. 326.92, subd. 1. 1 also acknowledge that all licensed contractor's pay into the
Contractor's Recovery Fund, which can pay homeowners up to $50,000 in the event that their
licensed contractor fails to complete work or preforms defective work, but that I forfeit my
rights to reimbursement from the Contractor's Recovery Fund in the event that any
contractors I hire are unlicensed.
I also acknowledge that as the contractor on this project, I am solely and personally responsible
for and violations of the State Building Code and / or City Code in connection with the work
performed on this property, and that I can be prosecuted criminally for any code violations
that are not corrected as ordered by the City.
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Signatur of Property Owner Date
To determine whether a particular contractor is required to be licensed, please call the
Department of Labor and Industry @ 651-284-5012
Carb Monoxide alarms
Bd 1
are r fired 10' from bedrooms
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oke Detectors: Hard Wire with batt
backup; Locate in each sleeping rooff
cofridolr / sleeping room access, on ear
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Seal All piarl t"a'k,{• ; ouna
Duct, Pips and Wits ThroUgh
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APPROVED FILE COPY
REVIEWED FOR CODE COMPLIANCE
SUBJECT TO FIELD INSPECTION
Date: q-$:— — ---
Signature:
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