2017-00767CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS 6295 86TH ST NE
PIN 155186001030
LEGAL DESC CARLISLE VILLAGE 3RD ADDN
LOT 003 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE ROOFING
VALUATION $ 17,485.20
APPLICANT
GRUSSING ROOFING
6929 RAVEN COURT
EDEN PRAIRIE, MN 55344-
OWNER
CHAD & TRACY, HINZ
6295 86TH ST
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
1111111111111111111
Z 0 1 7— 0 0 7 6 7*
DATE ISSUED: 10/16/2017
Permit #: 2017-00767
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
Payment(s)
CREDIT CARD 4426
310.85
8.74
319.59
319.59
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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ROOFING EXTERIORS INC MWIV DRA GRUSSING ROOFING
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1.-2019 6921 RAVEN # T DEN PRAlR4--.:,1 -N
55340 VERIFY UP-TO-DATE
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