2021-00027CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX (763) 295-4404
ADDRESS 4183 87TH ST NE
PIN 155252001020
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 002 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE BASEMENT FINISH
VALUATION $ 16,800.00
NOTE: BASEMENT FINISH: I BEDROOM, I FAMILYROOM, AND 13/4 BATHROOM
APPLICANT
PEARSON, GREGG & ALANA
4183 87TH ST NE
MONTICELLO, MN 55362-
OWNER
PEARSON, GREGG & ALANA
4183 87TH ST 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
2021-00027*
DATE ISSUED: 01/12/2021
Permit #: 2021-00027
BUILDING PERMIT FEE 296.01
PLAN REVIEW 192.41
STATE SURCHARGE, BLDG VAL 8.40
TOTAL 496.82
Payment(s)
CREDIT CARD 496.82
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF Permit No.
Monticello
BUILDING SAFETY Date
RESIDENTIAL BUILDING PERMIT
ADDITION / ALTERATION / REMODEL
SITE ADDRESS
qlb3 07* Si M57! M zm h cello, MN 663&• Z
LEGAL DESCRIPTION
LOT 062, BLOCK ,//,D/01 PI.D. NUMBER/ 56- Z2- y'OD/OZO
PLAT P&'r"'v JhG W? fiUNl-7i41j
G lana ` 6v a Pe sol? 03 9 5) ; fNEB 00 dlo,, IN 3?01.Nei 15740 OWNEIt (
Nam) CONTRACTOR (
Name) (Address) (Tel. No.) CONTRACTOR'
S LICENSE NUMBER (IF APPLICABLE) PLUMBING
BEING COMPLETED BY (PLEASE CHECK ONE): HOMEOWNER
X CONTRACTOR IF
APPLICABLE, SPECIFY CONTRACTOR Lic # CHECK
ALL THAT APPLY: X TOILET X SINK BAR SINK X BATHTUB/SHOWER LAUNDRY
TUB bur t rr.c.% OTHER TOTAL #
OF FDnvm 3 REMINDER:
KF YOUDO NOT 0WNTHIS PROPERTY OR ARE NOT PERFORMING THE `PORK:, PERMIT MUST BE PULLED BYA
MASTER PLUMBER.) MECHANICAL
BEING COMPLETED BY (PLEASE CHECK ONE): HOMEOWNER
CONTRACTOR IF
APPLICABLE, SPECIFY CONTRACTOR CHECK
ALL THAT APPLY: FURNACE A/C FIREPLACE X BATHFAN TOTAL #
OF FDITURES Bond # DESCRIPTION
OF WORK: — 12 x tg' QA9,,,, / j— '31))(, 22 ' poor..' 8
r Fhlsh l
Alp"t ly P 0 A® lo, 3IY tb4r!7k-w 7 l - 3/1 &,-f 4 Qoo*. MWATED
VALUE OF CONSTRUCr10tj 00
Approved by Building Official: AZ444_
Data Approved Applicant
Signature . "I. Date SOS
Walnut Street, Suite #1 MontieeAo, MN 55362 Phone: 763-295-3060 Fa:: 763-295.4404 t-) (' -'
L q9
CITY OF
PHONE:763-295-2711 FAx:763-295-4404M0fiiiCR---,,ff0 505 Walnut Street ui 1Suite Monticello, MN 55362
0
BUILDING PERMIT APPLICANT: PROPERTY OWNER
I understand that the State of Minnesota requires that all residential building contractors,
remodelers and roofers obtain a state license unless they qualify for specific exemption from
the licensing requirements. By signing this document, I attest to the fact that I am building or
improving the house myself. 1 hereby claim to be exempt from the state licensing requirements
because I am not building or improving property for the purpose of speculation or resale and
that the house which I am applying for this permit located at: +a3 ?)-V'" 51- N ]
is the first residential structure that I have built or improved in the last 24 months. I also
acknowledge that because I do not have a state contractor's license, I forfeit any mechanic's
lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. In the even
that I do construct or improve another residential structure in the next 24 months, I will not do
so until I obtain the required state license understanding that failure to do so is a misdemeanor
under state law.
Furthermore, I acknowledge that I may be hiring Ind pendent contractors to perform certain
hisaspectsoftheconstructionorimprovementoft ouse and I understand that some of these
contractors may be required to be licensed by the State of Minnesota. I understand that
unlicensed residential contracting, remodeling, and / or roofing activity is a misdemeanor under
Minn Stat. 326.92, subd. 1. 1 also acknowledge that all licensed contractor's pay into the
Contractor's Recovery Fund, which can pay homeowners up to $50,000 in the event that their
licensed contractor fails to complete work or preforms defective work, but that 1 forfeit my
rights to reimbursement from the Contractor's Recovery Fund in the event that any
contractors I hire are unlicensed.
I also acknowledge that as the contractor on this project, I am solely and personally responsible
for and violations of the State Building Code and / or City Code in connection with the work
performed on this property, and that 1 can be prosecuted criminally for any code violations
that are not corrected as ordered by the City.
Z)
nature of Property Owner Date
To determine whether a particular contractor is required to be licensed, please call the
Department of Labor and Industry @ 651-284-5012
www.ci.monticello.mn.us
Innate walls & Ceilings with sealed
vapor retarder per Energy Code.
42W
II• . OOtlO' - oft
uv U VAUAIN AD
Smoke Detectors: Hard Wire with battery
backup; Locate in each sleeping room,
corridor / sleeping room access, on each
story, in basement, And where ceiling height
varies 24" +,
W-0 q.2 n o I V Y ur I % Nf I. 1-6 I•
v _ G„-_---_______ low&Y srl.IW _ C b n Monoxide alarms
p ions
t • __ ---== -===-= - ______ "=-=---= '- ='--' -- °--; arw required 10' from bedrooms
Separate I erinit 1 . - _-- _-- _ _ _ _ _,
Required For Eieci"l Work I t
t t ^ I I i• MS 299F.5®
I I sae a umJs to o c. 1 . I I I I a* IMM. PI.T. IO„ I 1 I I GCMG. AC40 8 6' OrG MAX I }
ft .reae'arSl lag Jm= All Bottom Wall Plates in Contact
Clur Opening 5.7 Sq. Ft. Ii1M. "dY1lip1i ei0ncrete or Masonry I We
I .:
c..,.,...+1 FAMILY I OM Decay IIVUta4SNInotmorethan 4' ,t = I i , o I B Inished
Floer. S
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rnlAem WALt.6 GLAD deal Ail Pewiat-atronm Around I •'.
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11CM Fed wentiiatlew nd: 1 I ,,,4` DO=AND WALLS 1 p 6
Far Shall BeVented and ft LShFollowI1'.. Fp2 BL®CKiNG Qfijlii: I
elate. I to Building Exterior I ;; i I` i ° i i p r61' ' e t t I
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I Enclosed Spec under Stairs: 6W ¢
Y+• 4• i i i _ t`" I "cover with 112 inm Gypsurn Board I
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1 20W 4040M. low PO]4111D WALLS ( I I I I
eoNe. r1NGNO111 6o o.G. t - ALI JOB DEBRIS MUST BE CONTAINED p I:
I ISO" IN IUL FM c m t :r I ------- ----- r I I (7N-SITE AND IN A DUNIPSTER OR 2ox6•
GONG. . L-------= IJ ' '° -•.. , % , j :,ROOMI CODED
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APPROVED FILE
COPY o
REVIEWED FOR CODE
COMPLIANCE o SUBJECT TO FIELD
INSPECTION uatpI—ll-20 s