2011-00085CITY OF MONTICELLO
505 WALNUT STREET .
MONTICELLO, MN 55362-
295-3U6U 1"AX: (763) 295-4404
REPRINTED ON 2/22/2013
ADDRESS 9320 CEDAR ST S
PIN 155169001010
LEGAL DESC MONTICELLO BUSINESS CTR 3RD ADDN
LOT 001 BLOCK 001
PERMIT TYPE BUILDING
f
PROPERTY TYPE COMMERCIAL
CONSTRUCTION TYPE TEMPORARY
VALUATION 500.00
NOTE: ERECTION OF TEMP TENT 39 X 59
APPLICANT
WAL-MART REAL EST BUSINESS TR
1301 LOTH ST SE
PROP TAX DEPT #8013
AR 72716-0555
OWNER
WAL-MART REAL EST BUSINESS TR
1301 LOTH ST SE
PROP TAX DEPT #8013
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
2 0 1 1- 0 0 0 8 5*
DATE ISSUED: 03/31/2011
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
PAID WITH CHECK # 10022207
24.91
5.00
29.91
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
DEVELOPMENT SERVICES PL-RNUT»
BUILDING INSPECTIONS PID
r
i
l 50511'ALNUT STREET. SUITE 1
i L;ri l t. f NIONT IC E L LO. V1N 55363
NIONTICELLO City Hall (763) 295-271 I Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Please Print - t\CO,MPLE'rE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: Walmart parking lot - 9320 Cedar Street ZONEI)___
LEGAL: Lot Block Plat
Property Owner Name: Walmart Stores, Inc.
V
pllolle: 123-456-_7_890__ _
Address: 702 SW 8th Street City: Bentonville StatL' AR Zip: 72716
Contractor Name: TNT Fireworks Pllotle: 800-225-6529
State License:
Address: 5401 West Skelly Drive City: Tulsa State: OK Zip: 74107_
Eng./Architect Name: Phone:
Address: City: State: _ Zip:
Plumber Name: Phones:
Address: City: State: Zip:
i\lechanieal Nanie: Phone:
Address: City: State: Zip:
Type of Work Type of Construction Building Information
New Single Family Use of building
Addition Duplex of stories
Alteration Multi -Family Floor area scl. ft.
Repair COi11111creial Estimated \•aluc
move Industrial of construction S
Other tent Residential Garage Is this tr "Master l'l:nt" per.NIN Rule
Otlier Tent 1300.0160 Subp.6Y Yes Nn
Description of work: erection of tent _ _ _- FOR ROOFS SIDING PERMITS,
PLEASE PROVIDE 9 OF SQUARES
OF SHINGLES S/OR SIDING.
I hereby apply for a pennit 11or construction as described and acknowledge that the intihmuttion I have provided above is complete and uccurate. I
agree that the work %%ill he conducted in confiormance with the ordinances of the City of \Monticello and with the Liws of the state of M inncsota:
and that I understand that this application is not a pennit and that the work is not to start without a pennit. I further understand that the work
hill 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 gill be repaired at my expense.
SEE BACK FOR PLUMBING
AND \MECHANICAL INFO.
Application Date
APPf ICANT: Plc-rrse slrrrrr %LY11U cis tlttrl m e a1 Ulicuble.
Fire Suppression : (if applicable) 1'lumbin,,: (i/'upplic•uble) Ileclxrrticrrl: (if (tpplic uhlc•)
No. Fixture •R•ue u. Fixtln•e 71•pc u. Fixture TvL
sprinkler Witter Chisel Roilet) hirrnurr•
Other) Special FS Devive lathntl, Gas .lk4er
Lut'rttort' (mush basht) ilatrre /lout/
Shower Gas Rim,c
Kitchen Sink tl itcv Dearer
Dishwasher tit C•oadiliouill,-
Lamit rr Tnb Hec•h. Fireplace
Clothes Ifusher Hu1hrount(s) L•xham%l Full
Fire.-Ilarm. (ifapplie•able,)
Water Herter Air Exchimger
c rinrtl Dryer
No. Fixture Tvue Drinkiug Fountain Gus Openia; u•iu Fimun,
Fbar Drain
a nJ'neriece Slop sink
other Il t'rb utts
S9 Per Fixture) S9 Per Fixt rre)
FOR CITY USE ONLY
Tree Ot•dinauce handout Yes \o
FEES: Other handouts Yes No
3h{s. Permit --- -- -- _ —
Plan Review — --- ---
State Su charge — -
Blde. Total _---
Pllll". Pe1111itlr —
Fixture; ------
Surrh:u-C
r
Phub. 'Total —_—`--
Mcell. Permit
Fixtures __-
sm•char-e
Mech. Total ---
Sewer Access
Water Access
N-leter Salts Tax ^
Nleter Total
Sew & Water Permit
Trunk \W,uer
I funk Sanitary Sewer
Trunk Storm Sewer
Lifi Station
TOTAL FEES:
ADDITIONAL INFO101ATION:
Valuation: ---------- - ..
cons, ruction__ --
Occupancy Ciruup: _-•----_-- —.
stluare Footage: _ - ------
ofStories:
of Residential units:
Maximum Occupancy.
Fire Sprinklers:
Off-Streei Parking Ca%•ercd: ---_-- _ --
Off-Street Parkin_.; Uncovered:__
Building official
Jun 24 10 09:46a Larry Jensen 763-427-8498 p.2
TNT FIREWORKS
A!V
A Tent Placement Worksheet must accompany each.and every Lease Acgfeemerd
STAND I TENT PLACEMENT WCRKSHEET
CITY.. 'STATE /L'I ZIP
t
TENT/ STAND SIZE
STORE NAME I LOCATION D
STMD I TENT SETUP DATES BETWEEN CJ -AND .Lo z
STAND ! TENT TAKE DOWN DATES BEWTEEN 72Z AND
NOM
PRO Np
i!
Apr
191