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2013-00211CITY OF MONTICELLO 505 WALNUT STREET MONTICELLO, MN 55362- 763) 295-3060 FAX: (763) 295-4404 ADDRESS 4332 87TH ST NE PIN 155180004070 LEGAL DESC FEATHERSTONE 2ND ADDN LOT 007 BLOCK 004 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 NUMBER OF PLUMBING FIXTURES 1.0000 APPLICANT HEIDELBERGER PLUMBING LLC 30132 105TH ST PRINCETON, MN 55371- 763) 631-0786 OWNER KANAGIE, OMAR 4332 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 2 0 1 3— 0 0 2 1 1* DATE ISSUED: 05/17/2013 PLUMBING BASE FEE, RESI 45.00 PLUMBING FIXTURES 9.00 STATE SURCHARGE, PLBG FIX 5.00 TOTAL 59.00 PAID WITH CHECK # XXXX L SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. DEVELOPMENT SERVICES BUILDING INSPECTIONS 505 WALNUT STREET, SUITE I jtjt tjj j;#tjtjt l MONTICELLO, MN 55362 City Hall (763) 295-2711 MONTICELLO PERMIT # i PID # Building Inspections (763) 295-3060 Fax (763) 295-4404 Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. SITE ADDRESS: 433 2 5( ( YV.E LEGAL: Lot Block Plat Property Owner Name: 0c/"1N-( 4flac: e5 Phone: Address: U 33,) 'J f City: M-V k, e ((a Contractor Name: State License #: Address: 360a Kede_c Eng./Architect Name: Address: Plumber Name: Address: Mechanical Name: Address: Tvne of Work New Addition Alteration Repair Move Other Descriptfop ofwork: ZONED State: / VIA Zip: f% Phone: 76 ? of 3 D 7(FC City: e(. we-e-6 State: MAJ Zip:.537 t City: City: City: Tvne of Construction Single Family Duplex Multi - Family Commercial Industrial Residential Garage Other Phone: State: Zip: Phone: Phone: State: Zip: State: Zip: Buildina Information Use of building of stories Floor area sq. ft. Estimated value of construction $ Is this a "Master Plan" per MN Rule 1300. 0160 Subp.6.? Yes No FOR ROOF & SIDING PERMITS i rr L PLEASE PROVIDE # OF SQUARES OF SHINGLES &/OR SIDING _ I hereby apple 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 Cite of Alonticello 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 cu _f -alk. public utilities and signs will be repaired at my expense. s SEE BACK 7—kc5AND MECHAONICAL INFO G pplosianiture Application Date U o© . APPLICANT. • Please show fixtures that are applicable. Fire Suvvression : (if applicable) Plumbing: (if applicable) Mechanical. (if applicable) No. Fixture Tvne Sprinkler Heads Other/Special FS Device Fire Alarm: (if applicable) No. Fixture Tvne of Devices Other FEES: Bldg. Permit Plan Review State SurchargeZLI Bldg. Total Plmg. Permit Fixtures Surcharge Plnrg. Total Mech. Permit Fi\tureS Surcharge Mech. Total Sewer Access Water Access Water Meter Meter Sales Tax Meter Total Sew & Water Permit Trunk Water Trunk Sanitary Sewer Trunk Storm Sewer Lift Station TOTAL FEES: No. Fixture TVDe I•I/ater Closet (toilet) Bathtub Lavatory (vash basin) Sh o ver Kitchen Sink Dish vasher Laundhy Trrb Clotlres Washer kVater Heater...•_•., _. Urinal Drinking Fountain Floor Drain Slop Sink Hydrants No. Fixture Tvpe Furnace Gas Meter Ran; e Hood Gas Range TVater Heater Air Conditioning illech. Fireplace Bathroom(s) E.ehrnrst Fan Dryer Gas Opening Wo Fixture TOTAL TOTAL 9 Per Fixture) ( $9 Per Fhture) 4`t Lg• p`5a 'C K'4 8 h? Z.F...y •.. 5a=' A. 1ya __ a4.,' .-t_z >....=;+` s„ '"si BFi.,.4't`•`..`.i°y"r'd.z..'4'k:.5.-,pop-R';-''xt,;i ICI'I'Y;TJSE O:NIIY°=?.a• • . # Tree Ordinance Handout Yes No Other- Handouts Yes No ADDITIONAL INFORMATION: Valuation: Construction Type: Occupancy Group: 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: