2008-01089CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
6-11 295-S000 F A X: 110.31 29n-44U4
ADDRESS 6288 86TH ST NE
PIN 155186001050
LEGAL DESC CARLISLE VILLAGE 3RD ADDN
LOT 005 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE ROOFING & SIDING
VALUATION 14,777.00
NOTE: FINAL INSPECTION TO BE CALLED IN A MAXIMUM OF 48 HOURS AFTER COMITE-HON
APPLICANT
GIDDINGS EXTERIORS
18001 UTE STREET
RAMSEY, MN 55303-
612)282-7379
OWNER
RUSSO,RICHARD
6288 86TH ST 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
2 0 0 8- 0 1 0 8 9
DATE ISSUED: 07/10/2008
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
Payment(s)
CHECK 9212
266.33
7.39
273.72
273.72
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
MONTICELLO
DEVELOPMENT SERVICES
BUILDING INSPECTIONS
505 WALNUT STREET, SUITE I
MONTICELLO, MN J>>62
PERMIT
P I D
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: -5 ZONED
LEGAL: Lot Block Plat
Property Owner Name: IC? /` '%5"- Phone:
Address: - ', `i 1 City:1 Git1 _( ,E'119 Statet1Zip:_ Contractor
Name: ; ' ?iC G7rZ L_L - Phone: + 1Z-'-Z9Z__-73 State
License L-:- Address:
i C I;Tf >T- City: State:Zip, t' ` Eno./
Architect Name: Phone: _ Address:
City: State: _ Zip: Plumber
Name: Phone: Address:
City: _ State: lip: Mechanical
Name: Phone: Address:
City: State: Zip: Type
of Work Type of Construction Building Information New
Single Family Lase of buildirW1 Addition
Duplex a of stories Alteration
Multi -Family Floor area sq. It. Repair
Commercial Estimated value Move
Industrial of construction S Other
Residential Garage Is this a "Master Plan" Per MN Rule Other
1300.0160 Subp.6.? Yes No r
F 3 ` l,"" `t) FOR ROOF & SIDING PERMITS Descriptioofwork: 0C
PLEASE PROVIDE # OF Cj /)/
r r f + , Y i SQUARES OF SHINGLES &/OR SIDING
I
heretw for a hermit for construction as described and acknowledge that the infom;ation I have prOv idecl above is complete and accurate. I agree
that the \r oi-k will be conducted in conformance with the ordinances of the Cite of Monticello and rcith the I.a\is of the Butte of i linnesota: Lill,!
that I uncicrstancl that this application is not a permit and that tir \orl: is not 10 start \vithout a permit I further understand that the v%orl< kill he
in accordance with th,° plan that has heen approved by the Building Official. I grec that any damagc caused to puhlic property including but not
limited to cm-h. sidewak puhlic utilities and signs %vill he repaired at 111v expense. LkX414eanI
Siunature SEE
BACh FOR PLUMBING AND
MECHANICAL INFO. Application
Date
A PPI.1('A NT- Plnace .chew fixtures that are applicable.
Fite Suppression : (if applicable) Pltunbitr,: (if applicable) Mechanical: (if applicable)
No. Fixture Type
Sprinkler Heads
No. Fixture Type
Water Closet (toilet)
Lavatorp wash rasin
Shower
No. Fixture Type
Furnace
ange Hood
Gas Range
Kitchen Sink Water Heater
Dishwasher Air Conditioning
Laundt-V Tub Mech. Fireplace
Fire Alarm: (If applicable) Clothes Washer
Water Heater
Bathroom(s) Exhaust Fan
Air Exchanger
No. Fixture Type
V'rival
Drinki rg Fotrntaitt
Drper
Gas Opening w/o Fi_rture
Floor Drain
of Devices Slop Sink
Other Hydrants
TOTAL
S9 Per FLvture)
TOTAL
9 Per Fixture)
FEES:
Bldg. Permit
Plan Review
State Surcharge
Bid-. Total
Plm,_,. Permit
Fixtures
Surcharge
Plmg. Total
Mech. Permit
Fixtures
Surcharge
Mech. Total
Sewer Access
Water Access
Water Meter
Meter Sales Tax
Meter Total
Sevv ck Water Permit
Trunk Water
I rural: Sanitary Se xer
Trunk Storm Sewer
Lift Station
FOR CIFT Y TJ:SE t)NI;Y
Tree Ordinance I-landout Yes No
Other Handouts Yes No
ADDITIONAL INFORMATION:
Valuation:
Construction Type:
Occupancy Group:
Division:
Square Footage.
of, Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: 'es No
Off -Street Parking Covered:
Off -Street Parking Uncovered:
Building Official
BPT:
TOTAL FEES: