2008-01387CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
FlolUFLLM1111I1 W V:Rff1iMW l. 1! III
ADDRESS 6291 86TH ST NE
PIN 155186001040
LEGAL DESC CARLISLE VILLAGE 3RD ADDN
LOT 004 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE SIDING
VALUATION $ 7,000.00
NOTE': FINAL INSPECTION TO BE CALLED IN A MAXIMUM OI' 48 HOURS AFTER COMPLETION
APPLICANT
CONTONS,MATTHEW & KRISTIN
6291 86TH ST NE
MONTICELLO, MN 55362-
OWNER
CONTONS,MATTHEW & KRISTIN
6291 86TH ST N E
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 3 8 7
DATE ISSUED: 07/21/2008
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
Payment(s)
CHECK CC
147.61
3.50
151.11
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
DEVELOPMENT SERVICES PERMIT
BUILDFNG EN'SPECTIONS PID
505 WALNUT STREET. SUITE I
tONTICELLO. %IN 53362
Cite Hall (763 )?95-2711 Building Inspections (763) ?95-3060 Fax (7631 ?95-4404
MONTICELLO
BTTIL ING F+ij' APrP;AT OT
Please Print - INCOMPLETE APPLIIC//ATIONS WILL NOT BE ACCEPTED,
SITE ADDRESS: u'' `/ C>C 5(r /L' ZONED _
LEGAL: Lot Block Plat
Name: Z S Phone: Property Owner ti ,
1,
Address `( _ City: ti cr c State: Zip:: j 3Ez
Contractor Name: Phone: _
State License
Address: City: State: Zip:
Eng./Architect Name:
Phone: _
Address. City: State:
Plumber dame: Phone:
Address: City: State: Zip:
Mechanical dame: Phone:
Address: City: State: Zip:
Tvpe of Work Type of Construction Buildin6 Information
New Single Family Use of building
Addition Duplex of stories
Alteration Multi -Family Floor area sq. ft. _
El Repair Commercial Estimated value
Move Industrial of construction S -
Other ElResidential GaraLc Is this a "Master Plan'' perNNIRule Other
1300.0160 Subp.6.:' ElZ es El No FOR
ROOF & SIDING PERMITS Descriptionof N ork: PLEASE
PROVIDE # OF SQUARES
OF SHINGLES &/OR SIDING
i
aci o ; 01 tr , uo, as d s mcd and actin n n ntorr,siio I a pr %ic hcwe comr u a m osdt
icic lin conicimiance with the and r%ith t Lana or the Sin o'Murr na"
is no snit and that tn,- no; ',c, a o -m!t i n-tiIer uncterstant a a' .h ccr: nci
be ;
crdu_ ,.,., ,;ur ti at i.a 7 en apniore. o the Btnloir_ C)ffcia cause to public prop rrl inciudir- ou_ s ';
r' •
ci' be .eoa red at m xruns_ SEE
BACK FOR PLUMBING AND
MECHANICAL INFO. Applicant
Signature Application Date
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 a specific exemption
from the licensing requirements. By signing this document, I attest to the fact that I am
building or improving this house myself. I hereby claim to be exempt from the state
licensing requirements because I am not building or improving this property for purposes
of speculation or resale and that the house for which I am applying for this permit,
located at 11 ` ( V-ti S A; e- , is the first residential structure I have built
or improved in the past 24 months. I also acknowledge that because I do not have a state
license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled
under Minn. Stat. §514.01. In the event 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. I also acknowledge that all licensed
contractors pay into the Contractor's Recovery Fund, which can pay homeowners
up to $50,000 in the event their licensed contractor fails to complete work or
performs 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 any violations of the State Building Code and/or city ordinance in
connection with the work performed on this property, and that I can be prosecuted
criminally for any code violations that are not corrected ordered by the City.
ignature of Property Owner
C,t
Date
To determine whether a particular contractor is required to be licensed, or to check
on the licensing status of individual contractors, please call the Minnesota
Department of Commerce, Market Assurance Division, at (651) 296-2594, or toll -
free at 1-800-657-3602.