2021-00241CITY OF MONTICELLO
505 WALNUT STREET * 2 0 2 1— 0 0 2 4 1*
DATE ISSUED: 04/02/2021
MONTICELLO, MN 55362-
763) 295-3060 FAX (763) 295-4404
Permit #: 2021-00241
ADDRESS 4151 87TH ST NE
PIN 155252001060
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 006 BLOCK 001
PERMIT TYPE PLUMBING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE WATER SOFTENER
NUMBER OF PLUMBING FIXTURES 1
APPLICANT PLUMBING BASE FEE, RESI 50.00
PLUMBING FIXTURES 9.00
UCLLIGAN WATER
STATE SURCHARGE, PLBG FIX 1.00
1ST ST NE
BUFFALO, MN 55313- TOTAL 60.00
763) 682-2762 Payment(s)
CHECK 173710 60.00
OWNER
ZAWATZKE, MICHAEL & BRENDA
4151 87TH 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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Monticello
BUILDING SAFETY
SITE ADDRESS
1-1) S g-3!
LEGAL DESCRIPTION
LOT
PLAT
Permit No. t ——L 1
Date
RESIDENTIAL BUILDING PERMIT
ADDITION / ALTERATION / REMODEL
S r Alt,, AbfTt-(.,b-Uo M
BLOCK
OWNER (Name) (Address)
101w-c ZA T E Li 3 !:D' 5!
CTOR (Name) (Address) S11r
II r S " T- CONTRACTOR'
S LICENSE NUMBER (IV APPLICABLE) LITJTO
f6-
mw t6 AA-
1,,,&Lo PLUMBING
BEING COMPLETED BY (PLEASE CHECK ONE): HOMEOWNER
CONTRACTOR IF
APPLICABLE, SPECIFY CONTRACTOR CHECK
ALL THAT APPLY: TOILET SINK BAR SINK LAUNDRY
TUB I SOFTENER TOTAL #
OF FIXTURES Lic #
Tel.
No.) C34c)
N('3C)-q Tel.
No.) BATHTUB/
SHOWER OTHER
REMINDER:
IF YOU DO NOT OWN THIS PROPERTY OR ARE NOT PERFORMING THE WORK, PERMIT MUST BE PULLED B
Y A MASTER PLUMBER) MECHANICAL
BEING COMPLETED BY (PLEASE CHECK ONE): HOMEOWNER
CONTRACTOR IF
APPLICABLE, SPECIFY CONTRACTOR CHECK
ALL THAT APPLY: FURNACE A/C FIREPLACE BATHFAN TOTAL #
OF FIXTURES Bond # DESCRIPTION
OF WORK: 5 ®
ice'` L - -t;S'r(,1 \ ESTIMATED
VALUE OF CONSTRUCTION Approved
by Building Official: 900-
Date Approved: Applicant
Signature _P /J_ _ ' (SUff 4th (t(Date J/ 31 h, 1 505
Walnut Street, Suite #1 Monticello, MN 55362 Phone: 763-295-3060 Fax: 763-295-4404,