2008-01692CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
631 29s-3U6U VAN: I '1631 195-44U4
ADDRESS 6317 86TH ST NE
PIN 155186001010
LEGAL DESC CARLISLE VILLAGE 3RD ADDN
LOT 001 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE DECK
VALUATION 3,192.00
NOTE': 14'X14'. 4'XTAN D 4'X4' DECK ADDITION APPLICANT
VANDERLINDEN,
JAMES 6317
86TH ST NE MONTICELLO,
MN 55362- VANDERLINDENJAMES
6317
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 6 9 2 DATE
ISSUED: 08/04/2008 BUILDING
PERMIT FEE STATE
SURCHARGE, BLDG VAL TOTAL
Payment(
s) CHECK
Cc 103.
09 1.
60 104.
69 104.
69 SEPARATE
PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
4
MONTICELLO
DEVEL OPiN1ENT SERVICES
BUILDING INSPECTIONS
M(A Cie H L(l. M\ j; fie
City Hall (763) ?9j-?71 1 Building Inspections ('703) 295-', )6i) Fax (76 ) '_9 -4404
BUILDING PERMIT APPLICATION
Please Print - INCOMPLETE APPLICA FIONS WILL. ;LOT BE ACCEPTED.
SITE ADDRI SS: l031 - 6 s'-f 1 E1)
LLG_aL: Lot Bloch ._.._... . flat
T--
Plopert Owner dame: J-,K S ahe--(P,. P11one: / h = 743
33
ale E
Address: (D 3 — j
r City: f Ga-li oo tate: LI 1:
Contractor- Name: totLQi-';r,1 o.n I' lone: 3
State License =:
Address: G3 ('- _. gG._5 KE Cit} : State: Z111 5531+
Eng./Architect Name: ,wtt - =_ 3 j l...- 33a,o ~'T cla-r Phone.
Address: fr1 Cite: C Mate: Zi : 6-S3i:- ' fl _. _ l o
Plumber Name: — PIIolic:
address: C m : State: zip:
Mechanical !tank: Phone:
Address: Civ : State l 1:
Typc of Work Twe of Construction Btiddin; Information
New
Addition
Sin"Ic ['111111V
Duplex
I,'se ofbU1ldino ,-
of stories
Alteration Cl Flu1tl Family Moor area Sq. ft.
Repair Commercial timated vvalue
N'lo\ c Industrial o construction S
Other Residential Garat,c
C}tllet
Is this a -Master Plan" per NIa Rule
1300.0160 Subp.6? El Yes +_ No
Description of Fork: Pee—K EIev4t.a d' FOR ROOF & SIDING PERMITS
PLEASE PROVIDE 4 OF SQL'ARL;S
RR A,101a Gil/ lO. i7v OF SHINGLES &IOK SIDING.
i
tt 1c'!) iil'ht 1,11'1 I)CM111 tOr _i'i ic"1-i6cd'1nd dint ,.t1c' 1(it01.1li'Itlon i h} !t .: I7. Uzi told i; ;:omp jI:tc.tih. I
Iz,rtc thin the E'c 61 "%ith the ordin; cc' of thc Gity of `aonttc fio acid ith tltc o ihc tittti 1lil c oti: and
th i:1 = ndcl'tanl that 'hi, alp ':tnitn, ,s not a r':rwit a.rtl that the Gkork i- riot to ..iatt ; ithout a ilc:mix. I i'ul-licl uwldc: <ti1m ;hat 0)l: %wrk vil, :
re in'Iccwd,tncc v. it` ttic l r n that 1 1 ')ccn to [ho l3uildin,g Otti'ia3. I -nve that a cia n..,e C<W'cd tO Ilunik proprtc hcl not ';
united .0 t'urh. (SGiit;, UTilliic1i 1 t t ;l: 14€II 11t 1c;)air'2d .A W'\ c'ti lJc`155C. 01 SEE BACK
FOR
PLIINIB1 tG N1) N 11""
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Application Date l , t
f'Ic rtc slzo t f_ltirtc tlrll ale a trc tl tcr.
suppreisioll ._ fiJ aplrlic cahlc l F'Itartthiri: , (if crh tliccrh/c>) llcchunical: (r f 'applicable)
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FLecu(_ jt artr Closer ttnilet/ 1 rrrnacc Otlrer,%'
special I-S A icc BaNttuh Gas _Meter• Luratar} tr
rrslt htraitr) Ran,e Hood GiiS Ran-
e Kitchen Fink
11 ater Heater Dishwasher iN'
COIl lttiollin.; LauntlrY Tub
Mach. Fireplace Fire -harm: (
ifapplicable) Clothes it usher Bathroartt(t) L::elurtnt Fall IiuterHeater lirGrrhall-4.
r I 'rinal Dr_
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FFFS: FOR CITY UJSE ONLY
I ce 01 dinance
Handout Yes do Other Il;uulottfs Yes
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