2019-00730CITY OF MONTICELLO
505 WALNUT STREET * 2 0 1 9— 0 0 7 3 0*
DATE ISSUED: 10/25/2019
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
Permit #: 2019-00730
ADDRESS 4183 87TH ST NE
PIN 155252001020
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 002 BLOCK 001
PERMIT TYPE MECHANICAL
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NUMBER OF MECHANICAL FIXTURES 7
APPLICANT MECHANICAL BASE FEE, RESI 50.00
MECHANICAL FIXTURES 63.00
RICCAR HEATING
STATE SURCHARGE, MECH FIX 1.00
2387 STATION PARKWAY
ANDOVER, MN 55304- TOTAL 114.00
763) 754-4000 Payment(s)
CHECK 480111 114.00
OWNER
NOVAK-FLECK
8857 ZEALAND AVE N
BROOKLYN PARK, MN 55443-
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.
M9CITYnticello
ILDING SAFETY
pp
PERMIT
505 WALNUT STREET, SUITE 1 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.
3 6SITEADDRESS: 4I ! #- S'4- /v • E _ ZONED
LEGAL: Lot Block
Property Owner Name: - Novak -Fleck, Inc. Phone:
Address: 8857 Zealand Ave. N. State: Zip:
Brooklyn Park, MN 55445
Contractor Name:
RIGGAR AIR
Phone:
State License #: 91$7 STA-110N-1' e,;,N..4 E-Mail: M 1 Che(1C_ L r-L'D11 cC ,h I -&C_a n
Address: ANDOVER. MN 55304 City: State: Zip:
763-756_annn
Eng./Architect Name:
Address:
Plumber Name:
Address:
Mechanical Name:
Address:
Phone: .
jtv: We: Zip:
hone:
Zip:
Phone:
City: State: Zip:
Tvne of Work Tr a of Construction Buildine Information
14 New Single Family Use of building
Addition Duplex of stories
Alteration Multi -Family Floor area sq. ft.
Repair Commercial Estimated value
Move Industrial of construction $
Other Other
Description of work: -
tC+VUOYI
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.
Aicant Signature Application Date
SEE BACK FOR PLUMBING
AND MECHANICAL INFO.
APPLICANT. Please show fixtures that are applicable.
Fire ,Suppression : (if applicable) Plumbing: (if applicable) Mechanical. (if applicable)
No. Fixture Tvae No. Fixture Tvpe No. Fixture Tvae
Sprinkler Heads ter Closet (toile Furnace
Other/Special FS evice Bat tub Gas Meter
Lava ry (wash asin) Range Hood
Show Gas Range
Kitchen ink Water Heater
Dishwas r P Air Conditioning
Laundry b Mech. Fireplace
Clothes as er Bathroom(s) Exhaust Fan
Fire Alar`rt • applicable) Water eater Air Exchanger
Urinal Dryer
No. xture vae Drin ng Founta Gas Opening w/o Fixture
Floot Drain
of Devic S10# Sink
Other Ou ide Faucet
Future Owner Information:
Name:
Address:
TO AL TOTAL
FOR CITY USE ONLY
Tree Ordinance Handout Yes No
Other Handouts Yes No
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: / /