2019-00790CITY OF MONTICELLO
505 WALNUT STREET * 2 0 1 9- 0 0 7 9 0*
DATE ISSUED: 1 V19/2019
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
Permit #: 2019-00790
ADDRESS 6295 86TH ST NE
PIN 155186001030
LEGAL DESC CARLISLE VILLAGE 3RD ADDN
LOT 003 BLOCK 001
PERMIT TYPE MECHANICAL
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE GAS APPLIANCE
NOTE: INSTALL A GARAGE HEATER
NUMBER OF MECHANICAL FIXTURES 1
APPLICANT MECHANICAL BASE FEE, RESI 50.00
MECHANICAL FIXTURES 9.00
MONTICELLO PLMG, HTG & AIR
STATE SURCHARGE, MECH FIX 1.00
P.O. BOX 180
MONTICELLO, MN 55362- TOTAL 60.00
763) 878-0083 Payment(s)
CREDIT CARD 5949 60.00
OWNER
HINZ, CHAD & TRACY
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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
PLAT
CA -so.