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2017-00513CITY OF MONTICELLO 505 WALNUT STREET MONTICELLO, MN 55362- 763) 295-3060 FAX (763) 295-4404 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 ROOFING & SIDING VALUATION 8,500.00 APPLICANT MINNESOTA ROOFING COMPLANY 2402 COUNTY RD I SUITE #202 MOUNDS VIEW, MN 55112- 952) 451-1978 OWNER MEINHARDT, RONALD 6291 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 mmmffullmmmm 2 0 1 7— 0 0 5 1 3* DATE ISSUED: 07/18/2017 Permit #: 2017-00513 BUILDING PERMIT FEE STATE SURCHARGE, BLDG VAL TOTAL Payment(s) CREDIT CARD 0323 177.29 4.25 181.54 iF:iIRi1 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF Permit No. Monticello Date BUILDING SAFE RESIDENTIAL BUILDING PERMIT ADDITION / ALTERATION / REMODEL SITE ADDP" _ 1 / 1 '` LEGAL DESCRIPTION LOT BLOCK PI.D. NU LAMER PLAT OWNER (Name) (Address) (Tel. No.) kn S4 7,6 3 --, &66 -90-3q CONTRACTOR (N )' (Address) $7" (Tel. No. y pyaq 4 kJa q&R-W-1179P oiew CONTItACT0F6 ICT ER QF APPLICABLE) PLUMBING BEING COWL]= BY (PLE A,SB C=CK ONE): HOMEOWNER CONTRACTOR IF APPLICABLE, SPECIFY CONTRACTOR Lic N CMCK ALL THAT APPLY: TOILET BAR SINK BAMTUB/SHOWER LAUNDRY TUB SOFTENER OTC TOTAL # OF mTUREB REMINDR: IFYOUDO NOT 0WX MIS PROPERTY OR ARE NOT PERFORMING THE WORK, PERMIT MUST BE PULLEDE BXAM t 2 PLUAIMER.) MECHANICAL BBXNG COLLETED BY (P]M ASE CHECK ONE): ' HOMEOWNER CONTRACTOR IF APPLICABLE, SPECIFY CONTRACTOR CHECK ALL TiFLAT APPLY: FMACE A/C MEPLACE BATMAN TOTAL # OF FDTURES Bond # DE CRIPnONOF % 1a- 1t_ .SIB e h inns 1d x oK( R0a i F1'1/V ESTIMATED VALUE OF CONSTRUCTION Approved by BWdivg OMciaL- a.• r 1 '00 Dft Approved: Applicant Sig C' Date '7/ r7 505 Walnut Street, SoXte #1 Monticello, MN 5536. Phone: 763295-3060 Pax: 763 2954404 . cl 2 9 l ICI .lY1 Minnesota Department of Labor and Industry Licensing and Certification Services Construction Codes and Licensing Division —7 Phone: ' 651.284.5034 .. 443 Lafayette Rbad N • Email: 131.I.1.1cense0state.mmus . Saint Paul, Iii\N 5 155 Webslte: wWw.dll.mn.gov/ccld.asp NOTICES \ NOT TRANSFE§ABLE MINNESOTA ROOFING COMPANY CHANGE YOURBUSINESS STRUCTURE _, 2402 COUNTY RD I ' SUBMIT A NEW' PPLICATION FOR NEW ENTITY ST PAUL, MN 55112 ; SUITE#2V ' RENEW OR REOL'ACE INSURANCE POLICY ST PAUL, MN 55112 , SUBMIT NEW CERTIFICATE OF INSURANCE i; n n ..-..._ •'. r':~_ .. .._ +!'...+ .. T.,--.rnv,n,..n....., ••rv,.!.M y+m,M.....^v _.. Y •( .TI°. '.,.T._+7 T.•u!p'www•, 1 ...C,- .,,., w ,":' rYr° Crya"}...Ir• y'. rP' ,•+JN071FYiHE77DEfRTNINTOFA /}17ANGE:.IN YO,U° .BU$1 1!1ESS:. ;; ;':; :•:.: ,, ,_ , ;`;.':;'::a'• Failure to'do sn; subffi y.o4-Qp dmini;stral<Ive p altles bf.'' p:i ;`; Q Oi ; i ..' 15-Day. Notice R6quirement.,C ms llable, 1 0 '. re. Abv/CCLD/Licuada'te.e tgj•:.; 'Change inbusines'6;pFijri6dr,;'tf2'dtixiliot e.nurtitgr;:or'email dd e'ss; i ° b l: • . ''fir.• •:•;, ,Wa,. v.'u• •.n!:e.. 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MINNESOT: A'ROOFINOMf?`ANY'. Effective Date •:/,04/(j'I% 2016"' -2402` OUN1Y'•RD; I ^° '~ ;; °' Fa'iratioti.0ate 8 P :: a' m.i•:' :°p',=° ''0'. . '03/31Y.4 '•ST•PAIIL•''•MN;•5611•$•. •% "y •:'•.,,m°. If.. y Yr•„ _MM,tyR1 . N'.} SY: 'Sri'\'• •',% ' ^•.' .fVp •-.' 1^•: i VERIFY UP= fOAATE STAtC15„EkOWa[ Nb' R34 C 1 : Twww.dli mn.aov/cold/LI wri;v s$Q;TE.pr ll R,t r C:4 ._. Rti'r:.G: . . F-`.•...b~'. '' 9CP •. .. . . , rn; L t••6r •V r T•.'