2020-00293CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS 4139 87TH ST NE
PIN 155252001090
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 009 BLOCK 001
PERMIT TYPE PLUMBING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NUMBER OF PLUMBING FIXTURES
APPLICANT
RICKS PLUMBING INC
1707 221STAVE NW
CEDAR, MN 55011-
763) 753-1935
OWNER
NOVAK-FLECK
8857 ZEALAND AVE N
BROOKLYN PARK, MN 55443-
AGREEMENT AND SWORN STATEMENT
16
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
2020-00293*
DATE ISSUED: 04/10/2020
Permit #: 2020-00293
PLUMBING BASE FEE, RESI 50.00
PLUMBING FIXTURES 144.00
STATE SURCHARGE, PLBG FIX 1.00
TOTAL 195.00
Payment(s)
CHECK 17650 195.00
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Monticello
BUILDING SAFETY PERMIT # elf —)a 7P
505 WALNUT STREET, SUITE I MONTICELLO, MN 55362
City Ball (763) 295-2711 Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: f "_ ZONED
LEGAL: Lot 17 Block Plat _rl'
Property Owner Name:
Address:
Contractor Name: t0l (k S ; $
State License #: PC 6 cl2 e 6 '7.
CA
ddress: /' r 77-15el"
ngJArchitect Name:
ddress:
lumber Name:
Address:
Mechanical Name:
Address:
Tvve of Work
New
Addition
Alteration
Repair
Move
Other
Description of work:
IUCI-AJ
City:
rw
Phone:
State: Zip:
C- Phone: `-76S -
E-Mail: go e to p/wa 6, /.tee, p -i •st c-
City: CX—A ®' ' State. Zip: 1l
Phone:
City: State: Zip:
Phone:
City: State: Zip:
Phone:
City: State: Zip:
Tvve of Construction
J. Single Family
Duplex
El Multi -Family
Commercial
Industrial
Other
Building Information
Use of building
of stories
Floor area sq. ft.
Estimated value
of construction $
I hereby apply for a permit for construction as described and acknowledge that the information I have provided above is complete and accurate. I
agree that the work will be conducted in conformance with the ordinances of the City of Monticello and with the Laws of the State of Minnesota;
and that I understand that this application is not a permit and that the work is not to start without a permit. I further 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.
SEE BACK FOR PLUMBING
AND MECHANICAL INFO.
Applicant Signature Application Date
APPLICANT: Please show fixtures that are applicable.
Fire Suppression : (if applicable) Plumbine: (if applicable) Mechanical: (if applicable)
No. Fixture Tvne No. Fixture Tvue No. Fixture Tvue
Sprinkler Heads Water Closet (toilet) Furnace
Other/Special FS Device Bathtub Gas ]Meter
Lavatory (wash basin) Range Hood
Shower Gas Range
4 Kitchen Sink Water Heater
I Dishwasher Air Conditioning
Laundry Tub Mech. Fireplace
Clothes Washer Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) Water Heater Air Exchanger
Urinal Dryer
No. Fixture Tvue Drinking Fountain Gas Opening w/o Fixture
Floor Drain
of Devices Slop Sink
Other Outside Faucet
TOTAL TOTAL
FQR,CITY USE NLY
Future Owner Information: Tree Ordinance Handout Yes No
Other Handouts Yes No
Name:
Address:
City: ADDITIONAL INFORMATION:
Valuation:
State: Zip: Construction Type:
Occupancy Group:
Phone #: Division:
Square Footage:
of Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: Yes No
Off -Street Parking Covered:
Off -Street Parking Uncovered:
Building Official
BPT: / /