2021-00163CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS 4191 87TH ST NE
PIN 155252001010
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 001 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE : SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE : BASEMENT FINISH
VALUATION : $ 12,272.00
NOTE: BASEMENT FINISH: ONE BEDROOM AND ONE FAMILY ROOM.
APPLICANT
KNICK, SAWYAR
4191 87TH STREET NE
MONTICELLO, MN 55362-
OWNER
KNICK, SAWYAR
4191 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
1111111111111111111111
2021-00163*
DATE ISSUED: 03/1I/2021
Permit #: 2021-00163
BUILDING PERMIT FEE 236.65
PLAN REVIEW 153.82
STATE SURCHARGE, BLDG VAL 6.14
TOTAL 396.61
Payment(s)
CREDIT CARD 396.61
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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BUILDING SAFETY
IMAR 1 0 2021
Permit No.-. r — 0 0 1 X)
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Date
RF,SIDEi -T
ADDITION / ALTERATION / REMODEL
SITE ADDRESS
I e 7 r,l ` C t A'
LEGAL DESCRIPTION
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LOT BLOCK PI.D. NUMBER
PLAT
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OWNER (Name) (Address) (Tel. No.)
CONTRACTOR (Name) (Address) (Tel. No.)
5-e, I-F
CONTRACTOR'S LICENSE NUMBER (IF APPLICABLE)
PLUMBING BEING COMPLETED BY (PLEASE CHECK ONE):
HOMEOWNERS/ CONTRACTOR
IF APPLICABLE, SPECIFY CONTRACTOR Lic #
CHECK ALL THAT APPLY: TOILET SINK BAR SINK BATHTUB/SHOWER
LAUNDRY TUB SOFTENER OTHER
TOTAL # OF FIXTURES
REMINDER: IF YOU DO NOT OWN THIS PROPERTY OR ARE NOT PERFORMING THE WORK, PERMIT MUST BE PULLED
BY A MASTER PLUMBER.)
MECHANICAL BEING COMPLETED BY (PLEASE CHECK ONE):
HOMEOWNER *2 F' CONTRACTOR
IF APPLICABLE, SPECIFY CONTRACTOR
CHECK ALL THAT APPLY: X FURNACE A/C FIREPLACE BATHFAN
TOTAL # OF FIXTURES Bond # .
tDESCRIPTIONOFWORK: p^ Z C tA CA^AI i,'1e G f^ f f- I } kv I, L
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ESTIMATED VALUE OF CONSTRUCTION
01 Approved by Building Official:
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Date Approved: 1 I202%
Applicant Signature5 4 ' ` Date )n ems
505 Walnut Street, Suite #1 Monticello, MN 55362 Phone: 763-295-3060 Fax: 763-295-4404
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Carbon Monoxide alarms
are required 10' from bedrooms
per MS 299F.50
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" +,
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of 1 Dg
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mar Opening 5.7 WIN
W KW SRI not more than 4ir ftm Fills
W Floor. STATE
BOARD OF ELECTRICITY, separate
Permit & Inspectiorm Required
For Electrical Work I
All Penist: slbom Around Duct,
Pipe and Wks Through All
Top and Bottom FrESL®
CKING REQUIRED: Cut
Off Concealed Draft Openings Between
Stories & Attic, Chose Horizontal
to Vertical Penetrations. APPROVED
FU W" v
REVIEWED FORCODECOMA1'Iti SUBECT
TO FIELD IMPECilOII Patm
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