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2012-00115CITY OF MONTICELLO * 2 0 1 2- 0 0 1 1 5* 505 WALNUT STREET DATE ISSUED: 04/02/2012 MONTICELLO, MN 55362- 763) 295-3060 FAX: (763) 295-4404 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 NOTE: 30' X 50' TEMP TENT APPLICANT BUILDING PERMIT FEE 24.91 STATE SURCHARGE, BLDG VAL 5.00 WAL-MART REAL EST BUSINESS TR TOTAL 29.91 1301 LOTH ST SE PROP TAX DEPT #8013 PAID WITH CHECK # 10037280 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 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. DEVELOPMENT SERVICES I BUILDING INSPECTIONS a iNIONTICELLO• NIN 55362 P I D -I- _—. ...-.. _-._.._ . City Hall 76 95-371 I Buildin = Ins ections 763) 395-3060 Fax (76 ) ` 295-4 404 NIONTICELLO ( - BUILDING PERMIT APPLICATION Please Print- INCOMPLETE APPLICATIONS WILL NOT 13E ACCEPTED. SITE ADDRESS: Walmart parking lot - 9320 Cedar Street LEGAL: Lot Block Plat Property Owner Name: Walmart Stores, Inc. Phone: 479_273-4219 — Address: 2001 S.E. 10th Street C i ty: Bentonville State: AR Zip: 72716 Contractor Name: TNT Fireworks Phone: 701-400-7661 State License #: Address: 2109 59th Avenue South City: Fargo State: ND Zip: 58104 Eng./Architect Nance: Phone: Address: City: State: _ Zip: Plumber Nance: Pholle: Address: City: State:_ Zip: Meeltattieal name: Phone: Address: City: State: Zip: Tvve of Work Tvue of Construction Building Informatiott New Single Family Use of building Addition Duplex of stories Alteration Multi -Family Floor area scl. ft. Repair Conuncrcial Estimated value Move Industrial of constrttctian S Other E Residential Garage Is this at ••Master Plaur" peMNRule 011icl• 1300. 0160 Subp.67 Yes NO Description oftr- ork:Erection ofTent -- _ FOR ROOF & SIDING PER.MITS, PLEASE PROVIDE # OF SQUARES OF SHINGLES &/ OR SIDING. I hereby apply for it permit for construction .as that the intinmation I h,a%e provided abet%c is complete and accurate. I agree that the work till he conducted in conformance tt ith the ordin;utees of the Cit} of \lonticello and %%ith the Laws of the State ul' \linneaaa: and that I undersumod that this application is not a pennh ;mtl that the %%ork is not to start "ithout a permit. I tither understand that the work ill be in accordanec kith the plan than has been approved by the Building Official. I agree that any Jantage caused to public pngmrty including but not limited to curb. side talk, public utilities ;md signs a ill be repaired at uq expense. SEE BACK FOR PLUMBING iAND \MECHANICAL INFO. irAnt Sinnatur Appjilrltion ate t r t 4PPLIC-iNT: Ple(ise s/t())r fivtit)-es that ore (tppliruble f•h•e .Suppression : (if upplic•uble) Plunthiu,,: (if etpplie•ethle) 11ec•hurlicecl: (iPipplic•ublrl u. Fixture Tvue Nn. Vislurc Tvpc u. FiNturc Tvnc Spr;nkler Iierrcic tt finer Closer (toiler/ hin•julev Other /spec•iulIS Derive, Il Atub Gas.11etev Lavatory (crush hasin) Rtrtr a /lour! Shower Gus Ramw liirc•hen .Sink tt irrc r Ucvner Dishwasher lir C'onrlil;onill", biumilrr Tnh Mech. Firr/,lac•e Riv .-Ilprnr: (if applicable) C'(othes Washer Butlrroora(s) L•xhalr.+r Full Wafer Heater l it• Evcharr','cr• 1'rirru! firer n. Fi.\nu e'1'vue DrinkinA, Fountain Gus Openin,t u•io Fl1111T Flour Druht Slop .S'ink ether Ilydrunra TOTAL SJ Per Fivnn•rl 77) 7: IL S9 Per Fixtorel FOR CITY USE ONLY 1'rce Ordinance [fanclont Yes No FEES: Other IlandoutS 1 es \o Bldut Permit ----•----- Plan Review State Surcllitt•'_te 131(hy. Total P1111'1. Perlllit ----•- l• Ixllll't:i Surcluu•tsc Pleb. Total — — --- iceh. Permil — Hxtlu•cs Slll'e11:11'1e Mech. Toral •------- Sea er Access Watcr Acces;-- Water Meter deter Sille$ "fax- Nlcret- Total sew &. Water Permit Trunk Waler Trunk S,mitary Se„c, Trunk Storm Sc%Cr Lifi Station TOTAL FEES: AD1)I rio.N.m. INFORMATION: Valuation: —--------•--___-• Construction Type: Occupancy Group: Division: Square Fooalge: of Storics: --- --- _ __-_— elf Residential Units: axinttun Occupancy: ___.. Eire Sprinklers: Ye; L—J- No OR, st •ect Parkin- Covered: 0Cl=Su•ce[ Parking l;ncoverecl:-----•-----_._.__...__.__. Building official WaImart= ,. Save money. Live better. 2001 SE 101h Street Bentonville, AR 72716 Phone 479-273-4219' Fax 479-204-2263 April.crawford@wal-mart.com January 1st, 2012 To Whom It May Concern, American Promotional Events, Inc. dba TNT® Fireworks is an approved National Supplier for 2012 to conduct fireworks sales on our stores' parking lots where this type of promotion is legal. Events usually run 7 to 12 days with set up beginning approximately 5 days prior to the event. An American Promotional Events, Inc. dba TNT@ Fireworks representative will call you to introduce the company and discuss your participation in the event. Participation is encouraged and does add additional income to your other income account. The Store Manager must approve the store's participation and placement on the parking lot by store stamping the Pre -Sale Survey. All stores have researched and approved by the Walmart Realty Department. TNT@ Fireworks is responsible for obtaining all necessary permits and/or licenses and must display such permits and/or licenses at each location. Thank you in advance for your cooperation in this matter and if you have any questions, please contact Automated Consumer Services at (479) 273-4219. Best Regards, April Crawford Manager Consumer Services Walmart Stores, Inc. Jun-24 10 09:46a - Larry Jensen 1 763-427-8498 p.2 M A/ P 32() TNT FIREWORKS A Tent placement Worksheet must accompany eadh.and every Lease Agreement STAND /TENT PLACEMENT/ WORKSHEET ADDRESS "I J D OTY &le U 'STATE 144 Al Zip TENT/ STAND SIZE iY _S' STORE NAM E I LOCATI ON 0 ° lllaif+ STANDITENTSET UP DATES BETWEEN 11d 4 -AND 0 STAND l TENT TAI(E DDWN DATES BEWTEEEN71 AND 71P ww-.... rvv.J 3