2010-00316CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-301) YAX: (763) 295-44U4
REPRINTED ON 9/19/2013
2 0 1 0- 0 0 3 1 6*
DATE ISSUED: 06/28/2010
ADDRESS 9320 CEDAR ST S
PIN 155169001010
LEGAL DESC MONTICELLO BUSINESS CTR 3RD ADDN
LOT 001 BLOCK 001
PERMIT TYPE BUILDING
PROPERTY TYPE COMMERCIAL
CONSTRUCTION TYPE TEMPORARY
VALUATION 500.00
APPLICANT BUILDING PERMIT FEE 24.91
STATE SURCHARGE, BLDG VAL 0.50
WAL-MART REAL EST BUSINESS TR
TOTAL 25.41
1301 1 OTH ST SE
PROP TAX DEPT 98013 PAID WITH CC # 1005
AR 72716-0555
OWNER
WAL-MART REAL EST BUSINESS TR
1301 LOTH ST SE
PROP TAX DEPT 48013
AR 72716-0555
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.
06/25/2010 08:18 19184464827 TNT FIREWORKS PAGE 03/07
DEVELOPMENT SERVICES
BUILDING INSPECTIONS
505 WALNUT 5TRLLT. SUFFE 1
MONTTCtLLO. NIN 55362
NONTICFL U City Hall (763) 295-271 l
PIT) - --- - - -
Building Inspections (763) 29--3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Pleasc Print - INCONIPLE'r/II-}:\
PPLTCATIONS N\'TL(. NOT 13r ACCEPTED.
SITE ADDRESS: 1 I l—p.6-,_ jaJ
J
O G ZONED
LEG AL: Lot ' B13ck — Plat
Property Owner Name: _ q I/i 1 I _ IUieS _j'1G • Phone: 41'
Cit Ol1Ur( State: Address: %D _.
Contractor Name: Phone:
State License 4:
Address:C+ye C, City: Stale: Zi}kI
Eng./Architect Name: _-- Phone:
Address: _ City: State:_ Zip:
Plumber Name: Mimic:
Address: _ City: _ _ State: _ Zip:
Nlech.anical Name; _ ^ Phone:
Address: City: State: Zip -
Type of Work Type of Construction Building Information
New Single Family Usc ofbuilditig
Addition Duplex # of stories
Alteration Multi -Family Floor area sq. ft.
Repair C:oirlmercial Estimated value
Move 0 Inclustrial of construction
Uther Residential GvmTe Is this a per 'tVIN Rule —
C] Other 1300.0160 SubpA? Cl Yes INo
Description of work: On_.--0f —__ FOR ROOF & SIDING PFR-vIITS,
PLEASE PROVIDE # OF SQUARES
OF SHINGLES &,/OR SIDING.
I hrrchy ;rly,h' f< r' a Itcrntit for cnnsu action J.,
IbJc>
crihcd and ackn0tcled c that the intnrm;ninn I ha'C prol'iilC0 ahocc is coi11p1 tt: and accurate. 1 agrcu al
Ille It'I- n'ill 11 ctilldll Cted ill conlorinoticc wllh the ordinances onlie Cily ol-:\Iot111Cc1117 and with the LOT of the SWle of Miltncsoix. and that I
undcr lond that this apl±licalion is not a permit rind lhot the work i. nut to ;tort without it permit. I funhcr under5tancl thar the work will be in
accordance n'itli the plan that has been approval he the Btlilclittg otilcinl. 1 agree that any (lom.igc cuuscd to public propertv including but nor limited
to curb, ,sidewalk, lxtblic ti6litics and :igus will he rcpaircd at nit' cx1m),se. 7 APr signature
nppll,
tine i3rate SEE BACK FOR
PLUMBING AND ME, CHANICAL
INFO.
06/25,12010 08:18 19184464827 TNT FIREWORKS PAGE 04/07
r
r1 PAI_IC;1.'7: Please shot fixtures fit lll are applicable.
Fire Syppr•es.cion : ({f upplieable) lumbin,: (if•upplic•rrhle) Mechanical: (if appli(rrhlu)
u_ I i uuc'llpc No. _••-Fixture fvpc M. Fistwc_T,p
Sprinkler Meads ff'"af r (loser O oilef) rowan•
Other/Specird I-S Devic,e, 13arhirrh Gus Alerer
Lavaron— ftrush hu.iin) Range Hood
Shu ver Gas Runge
N;irchen Sink
r
11'rtrrr Nc•ok•r
Di.ihiceisher Air ('(pllrliriollill,
LumfdrY Trrh Illech• T'ireplelcl,
e7nrhe- IGIVher 81111ll'narlll5) L,l•lluff.Cl !'fill
rirer,,-Ilarrr,: (rf applicable) fValcr ))e,rrro. lil' Eechurl^rn'
Nil. Drinkin;; Pommiirf Gnu 0j7rnin,: wIt, !" .ware
rlanr Drain
Slop .Sill!,
Orlrer
I SY Per 1'Lrtrn'c) SJ Per !' ixfrfre•1
FEES:
Hlci,r. l'L1'llltl
Tian Rwi —
Sl;llc SlR'Char'_'c------
Inr_. I'ermil
Tixftn'cs -- —
ICC11. I'rrntil
1'ISlttl'C -
Surcharsc -
FOR CiTY USE ONLY
free Ordinance Handood 0 Yes 11 IN
Other handouts Yes O No
I ch. Total
clver:\cuss
V;11cr Access
GValcr i\vIcicr
1cmr
deter fntal
Scw & VMCV PCIMIJl
Trunk \Vatrr ... .---
Trunic sanit;lry Scwrr ------
Trolik Slorm Sc\\cr
Lill Station
T01';A1. FEES:
Valuation:
OCCLII)MICN. Group:
cif Sthries:
of Residential units:
Firc Sprinkler~: a'cs Nu
Oft -Street Parkin!, Cclk'cred:
t)1Tsl'cct Parking I,111CM-t11'll:_-.____---