2015-00395iiiiiiiiiiiiiiiiiiiimmlillilillillillillillililICITYOFMONTICELLO *
Z 0 1 5- 0 0 3 9 5
505 WALNUT STREET DATE ISSUED: 06/19/2015
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS : 4313 87TH ST NE
PIN : 155180002120
LEGAL DESC : FEATHERSTONE 2ND ADDN
LOT 012 BLOCK 002
PERMIT TYPE : PLUMBING
PROPERTY TYPE : SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE : LAWN SPRINKLER
NOTE: NOT TO BE LOCATED IN PUBLIC RIGHT OF WAY
BACK FLOW PREVENTOR AND RAIN SENSOR ARE REQUIRED
TO BE CONECTED BY A LICENSED PLUMBER
NUMBER OF PLUMBING FIXTURES 1
APPLICANT PLUMBING BASE FEE, RESI 45.00
PLUMBING FIXTURES 9.00
COX PLUMBING
STATE SURCHARGE, PLBG FIX 5.0017041172NDAVENUESE
BIG LAKE, MN 55309- TOTAL 59.00
763) 263-2731 Payment(s)
CHECK 5732 59.00
OWNER
KRAFT, JOE
4313 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
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF Permit No.
Moiiikeffo DateBUILDINGSAFETY
RESIDENTIAL BUILDING PERMIT
ADDITION / ALTERATION / REMODEL
SITE ADDRESS
i-/3/3
LEGAL DESCRIPTION
LOT
PLAT
v- Iwen
BLOCK
tom s- -36'
PI.D. NUMBER
OWNER (Name) (Address) (Tel. No.)
7o—e ' oc7z* t--
CONTRACTOR (Name) (Address) (Tel. No.)
a C e 1-14w /7'? ".IA*'- A 244 -Z> Y-7
CONTRACTOk'S LICENSE NUMBER (IF APPLICABLE) (/
PLUMBING BEING COMPLETED BY (PLEASE CHECK ONE):
HOMEOWNER CONTRACTOR Y
IF APPLICABLE, SPECIFY CONTRACTOR ( ,6j jr P11"A L LC Lie #
CHECK ALL THAT APPLY: TOILET SINK JBAR SINK BATHTUB/SHOWER
LAUNDRY TUB SOFTENER s `'1 r&l' 4! OTHER
TOTAL # OF FIXTURES
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: S-u
ESTIMATED VALUE OF CONSTRUCTION
Approved by Building Official:
Applicant Signature
505 Walnut S eet, Suite #1 Monticello, MN 55362
Date Approved:
Date
Phone: 763-295-3060 Fax: 763-295-4404 /