2008-01484CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 VAX: (763) 295-44U4
ADDRESS 6308 86TH ST NE
PIN 155186001070
LEGAL DESC CARLISLE VILLAGE 3RD ADDN
LOT 007 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE ROOFING & SIDING
VALUATION 20,000.00
NOTE: FINAL INSPECTION TO BE CALLED IN A MAXIMUM OF48 HOURS AFTER COMPLETION
APPLICANT
INTEGRITY PLUS
13301 MAPLE KNOLL WAY
MAPLE GROVE, MN 5531 1-
612) 709-0637
OWNER
HALE, GRANT
6308 86TH STREET 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 4 8 4
DATE ISSUED: 07/30/2008
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
Payment(s)
CHECK CC
340.53
10.00
350.53
350.53
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
MONTICELLO
DEVELOPMENT SERVICES PER)vtfT 4 , - ( )I
BUILDING INSPECTIONS PID 0
505 WALNUT STREET, SUITE I
MONTICELLO, NIN 55362
City Hall (763) 295-271 1 Building Inspections (763) 295-3060 Fax (763) 295-4404
gi IrDIl_`''ERTx StPPx -ATTA` E
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: (D 30 'j -Sf N - ZONED
LEGAL: Lot Block Plat
f
Property Owner Namc: ' G 't tt t {__ Phone:
Address: 6 30 ( ` s f. J City: 114ICE (ln State: /-4 Zip:
Contractor Name: +e f (tics ffoInt e t,o1s 2,c,Phone: 7 3
State License #: c-)05'/
Address: '180o Sk 4 A 1"3o City: l I .now-k.— State: At AI Zip: S sSu/
Eng./Architect Name: Phone:
Address: City: State: Zip:
Plumber Name: Phone:
Address: City: State: _ Zip:
Mechanical Name: Phone: _
Address: City: State: Zip:
Tvpe of Work Type of Construction Building Information
New X Single Family Use of building
Addition Duplex of stories
Alteration N-lulti-Family Floor area sq. ft.
Repair Commercial Estimated value J
L] Move Industrial cf construction
Other Residential Garage Is this a "Master Plan" per t- N Rule
Other 1300.0160 Subp.6.? Yes No
Description of wor --
T ---
i
I hereby apply for a permit For construction as described and acknowledge that the information I have orovided above is complete and accurate I
a21ee th t the work will be conducted in conformance with the ordinances of the City- of Monticello and with the Laws of the Statc of Minnesota
and Chat I undcrsta-:d that this application is not a permit and that the work is not to start \vitliout a permit. I `urt)ier uncerstand that the vyork will
be in accordance ,th the plan that has been approved by the f3uitdin> Official. I agree that any damage caused to public property inelud'nc but
not limited to curb. ssuewatk, public utilities and signs will be repaired at my expense.
Applicant Signature
3
SEE BACK FOR PLUMBING
AND INIECHANICAL INFO. )
A plication Date
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