2016-00355CITY OF MONTICELLO *
2 0 1 6- 0 0 3 5 5
505 WALNUT STREET DATE ISSUED: 06/07/2016
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 PLUMBING
PROPERTY TYPE COMMERCIAL
CONSTRUCTION TYPE ALTERATION
VALUATION S 1,400.00
NOTE: CHANGE / REMOVE 4 AVB'S AND REPLACE WITH PVB'S - INSTALL 2 NEW PVB'S AT MOP SINKS
APPLICANT PLUMBING BASE FEE, COMM 100.00
STATE SURCHARGE, PLBG VAL 0.70
HARTY MECHANICAL
1600 1ST AVE NE
Payment(s)
TOTAL 100.70
AUSTIN, MN 55912-
507) 437-8201
CASH 100.70
Minnesota State License #: PLBG-PC643063
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.
CITY OF
Permit No. Mon! tic;,llo
BUILDING SAFETY Dote
COMMERCIAL / INDUSTRIAL. BUILDING PERMIT APPLICATION
505 Walnut Street, Sane #1 Monticello, MN 55362 Phone: 763-295-3060 Fa:: 763-295-4404
SITE ADDRESS
LEGAL DESCRIPTION
LOT BLOCK PI.D. NUMBER
PLAT ZONDED
OWNER (Name) (Address)
UJ P M0, 7- c 3 ;- o k,4- 9v —76 3; — ;2R
OWNER'S E-MAIL ADDRESS: (Tel. No.)
CONTRACTOR (Name) (Address)
7-1 PVL
CONTRACTOR'S LICENSE NUMBER (IF APPLICABLE)
f, 61430()
CONTRACTOR'S E-MAIL ADDRESS:
ARCHITECT (Name) (Address)
ARCHITECT'S E-MAIL ADDRESS
ENGINEER (Name)
ENGINEER'S E-MAIL ADDRESS:
0
DESCRIPTION OF
WORK:
e
Address)
fti - fo
Tel. No.)
Tel. No.)
Tel. No.)
1,
N IV
TYPE OF WORK (Please Circle One) TYPE OF CONSTRUCTION (Please Circle One)
New Com-me
Addition Industrial
erahon Institutional
Repair Multi -Family
Move Other
ADDITIONAL INFORMATION MISC. NOTES:
Valuation: A 10
Construction Type:
Occupancy Group:
Square Footage:
of Stories:
Maximum Occupancy:
Fire Suppression: Yes No
ESTIMATED VALUE OF CONSTRUCTION
I hereby apply 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 City of Monticello and with the Laws of the State of Minnesota; and that I under-
stand that this application is not a permit and that the work is not to start without a permit. I further un-
derstand that the work will be in accordance with t e plan that has been approved by the Building Offi-
cial. I agree that any damage caused to public erty including but not limited to curb, sidewalk, pub-
lic utilities and signs will be repairea e.
Applicant Signature
Print Name /Title 2d 0 '2 -l. we 5-
6Date7
Approved by Building Official:
Date Approved:
d
CITY OF
COMMMonti6eflo ERCIAL &INDUSTRIAL PLAN
BUILDING SAFETY
SUBMISSION MATRIX
Project Title: U-V !9 0C e_ l5 P n•SP d L 0 P!J C Department Distribution
Project Address: a Z®
t~ v
v
All plans submitted for review must be 24' x36" size o
Arch D) or smaller. Larger plans will not be accepted. x
PROJECT TYPE
Check one pq
ara w • W ,
New Building Construction 2 1 1 18 la
Building Addition 2 1 1 18 le
Interior Remodel/Interior Tenant Build -out (no exterior site work)
2 1 0 0 0
Interior Remodel/ Interior Tenant Build -out (with exterior site work.
2 1 1 P P
e.g.: parking lot improvements/expansion, utility changes) I
Building Demolition 2s 0 0 18 I P
Site work (parking lot expansion, grading/drainage, etc.) 0 1 1 1 1
New Exterior Signage (Wall, monument, pylon, etc) 2 0 1 0 I 0
Mechanical (HVAC) permit 2 0 0 0 I 0
X\ Plumbing permit (more than 5 fixtures must be reviewed by the state") 2b 0 0 0 I 0
Fire Sprinkler or Alarm permit 3 0 0 I 0
Footnotes:
a. CivflPlans only. Budding plans not needed.
b. Plumbing projects with snore than 5 plumbing f mum must he submitted to the state for review poor to permit issuances Basic
pfumbiVEwwwplansmay bewquucdwith samebu,7daqgpvmwappAca SACdzaWm a Meplans
with survey iequieed for monument and pylon type signs d. "Civil
Plans" include; site plans, landscape plans, surveys, etc. as needed. Office use
only Date submitted: -
Distributed by
Plan review
submission matrix v2 Feb2014 (2).docx