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2021-00248CITY OF MONTICELLO 505 WALNUT STREET MONTICELLO, MN 55362- 763) 295-3060 FAX: (763) 295-4404 ADDRESS 4144 87TH ST NE PIN 155252002040 LEGAL DESC FEATHERSTONE 4TH ADDN LOT 004 BLOCK 002 PERMIT TYPE PLUMBING PROPERTY TYPE SINGLE FAMILY -DETACHED CONSTRUCTION TYPE NEW CONSTRUCTION NUMBER OF PLUMBING FIXTURES APPLICANT RICKS PLUMBING INC 1707 221ST AVE NW CEDAR, MN 55011- 763)753-1935 OWNER NOVAK_FLECK 8857 ZEALAND AVE N BROOKLYN PARK, MN 55445- 16 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 2021-00248* DATE ISSUED: 04/07/2021 Permit #: 2021-00248 PLUMBING BASE FEE, RESI 50.00 PLUMBING FIXTURES 144.00 STATE SURCHARGE, PLBG FIX 1.00 TOTAL 195.00 Payment(s) CHECK 18331 195.00 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF Monticello BUILDING SAFETY PERMIT # 71 4_2_ 505 WALNUT STREET, SUITE I MONTICELLO, MN 55362 City Hall (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: 4144 87th St NE LEGAL: Lot 4 Block 2 Property Owner Name: Novak Fleck Address: Contractor Name: Ricks Plumbing Inc State License #: PC642862 Address: 1701 221 st Ave NW Eng./Architect Name: Address: Plumber Name: Same as above Address: Mechanical Name: Address: TVDe of Work O New Addition Alteration Repair Move 0 Other Description of work: New home single family plumbing ZONED Plat Feather stone 4th Phone: City: State: Zip: Phone: 7637531935 E-Mail: Rickplumbinginc@gmail.com City: Cedar State: MN Zip: 55011 City: City: City: Tvae of Construction Single Family Duplex Multi -Family Commercial 0 Industrial Other Single family Phone: State: Zip: Phone: State: Zip: Phone: State: Zip: 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- 4.6.21 AND MECHANICAL INFO. Applicant Signature Application Date APPLICANT.- Please show fixtures that are applicable. Fire Sunnression : (if applicable) Plumbine: (if applicable) Mechanical. (if applicable) No. Fixture Tvve No. Fixture Tvue No. Fixture Tvue Sprinkler Heads 3 Water Closet (toilet) Furnace Other/Special FS Device 1 Bathtub Gas Meter 3 Lavatory (wash basin) Range Hood 2 Shower Gas Range 1 Kitchen Sink Water Heater I Dishwasher Air Conditioning Laundry Tub Mech. Fireplace 1 Clothes Washer Bathroom(s) Exhaust Fan Fire Alarm: (if applicable) 1 Water Heater Air Exchanger Urinal Dryer No. Fixture Tvne Drinking Fountain Gas Opening w/o Fixture 1 Floor Drain of Devices Slop Sink Other 2 Outside Faucet 16 TOTAL TOTAL FOR CITE' USE ONLY 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: / /