2020-00072CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX (763) 295-4404
ADDRESS 4147 87TH ST NE
PIN 155252001070
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 007 BLOCK 001
PERMIT TYPE MECHANICAL
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE FIREPLACE
NUMBER OF MECHANICAL FIXTURES
APPLICANT
HAGEN FIREPLACE SOLUTIONS
435 FAIRVIEW AVE
2
ST PAUL, MN 55104-
612) 839-7595
OWNER
NOVAK-FLECK INC
8857 ZEALAND AVE N
BROOKLYN PARK, MN 55445-
1
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
2020-00072*
DATE ISSUED: 02/21/2020
Permit #: 2020-00072
MECHANICAL BASE FEE, RESI 50.00
MECHANICAL FIXTURES 9.00
STATE SURCHARGE, MECH FIX 1.00
TOTAL 60.00
Payment(s)
CHECK 3473 60.00
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
mo lkeffo
BUILDING SAFETY
PERMIT #
505 WALNUT STREET, SUITE 1 MONTICELLO, MN 55362
City Hall (763) 295-2711 Building Inspections (763) 295-3060 Fax (763) 295-4404
B ''TILp NG P tMIT AP' LICATIQN
I 7 1 .. ., ,... .. .. ., i4. .._-..... ....... .. .... .,,...., .. ....
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: I Z-) % -9 % T 5 7—
LEGAL: Lot Block /
I
Plat
Property Owner Name: j-lc v-A, ram- Q U'% (d--i- -z'
Address: City:
Contractor Name: HAGEN FIREPLACE SOLUTIONS
State License #: BC649206
Address: 435 FAIRVIEW AVENUE City: ST PAUL
Eng./Architect Name:
Address:
Plumber Name:
Address:
Mechanical Name:
Address:
Twe of Work
New
Addition
Alteration
Repair
Move
Other
City:
City:
City:
Tvae of Construction
Single Family
Duplex
Multi -Family
Commercial
Industrial
Other
Description of work:
SET AND VENT GAS FIREPLACE - GAS LINE BY OTHERS
Phone:
ZONED
State: Zip:
Phone: (612) 839-7595
State: MN Zip: 55104
Phone:
State: Zip:
Phone:
State: Zip:
Phone:
State: Zip:
Building Information
Use of building RESIDENTIAL
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 )bate 2
APPLICANT: Please show_ fixtures that are applicable.
Fire Suppression : f applicable) Plumbing: (if applicable) Mechanical: (f applicable)
No. Fixture Tvoe No. Fixture Tvae No. Fixture Tvue
Sprinkler Heads Water Closet (toilet) Furnace
Other/Special FS Device Bathtub Gas Meter
Lavatory (wash basin) Range Hood
Shower Gas Range
Kitchen Sink Water Heater
Dishwasher Air Conditioning
Laundry Tub 1 Mech. Fireplace
Clothes Washer Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) Water Heater Air Exchanger
Urinal Dryer
No. Fixture Tvpe Drinking Fountain Gas Opening w/o Fixture
Floor Drain
ofDevices Slop Sink
Other Outside Faucet
TOTAL TOTAL
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j'JitGu.tjj A
Future Owner Information: Tree Ordinance Handout Yes No
Other Handouts Yes No
Name:
Address: I
City: ADDITIONAL INFORMATION:
State: Zip:
Valuation:
Construction Type:
Phone #:
Occupancy Group:
Division:
Square Footage:
of Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: Yes No
Off -Street Parking Covered:
Off -Street Parking Covered
Building Official
BPT: