2022-00249CITY OF MONTICELLO
505 WALNUT STREET
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 RPZ/BACKFLOW PREVENTER
VALUATION $ 4,015.00
NOTE: INSTALL (1) RPZ
APPLICANT
METROPOLITAN MECHANICAL CONTRACTOR
7450 FLYING CLOUD DR
EDEN PRAIRIE, MN 55344-
612)749-5697
OWNER
WAL-MART REAL EST BUSINESS TR
1301 10TH 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
Nuflfflulmullm
2 0 2 2- 0 0 2 4 9
DATE ISSUED: 05/02/2022
Permit #: 2022-00249
PLUMBING BASE FEE, COMM
STATE SURCHARGE, PLBG VAL
TOTAL
Payment(s)
CHECK 4473
G
100.00
2.01
102.01
102.01
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
LAPR
permitNo Moiii do - -
BUILDING SAFETY5 2022 Date
COMMERCIAL / INDUILVING I ERMIT APPLICATION
505 Walnut Street, Suite #1 Monticeuo, IVIIN 55362 Phone: 763-295-3060 Fax: 763-295-4404
SITE ADDRESS
9320 Cedar Street (Walmart #3624)
LEGAL DESCRIPTION
LOT np 1
PLAT Mon t, « 110
OWNER
BLOCK 00 1
S1 I&'S-s
OWNER'S E-MAIL ADDRESS:
Name)
CONTRACTOR (Name)
Metropolitan Mechanical Contractors
CONTRACTOR'S LICENSE NUMBER (IF APPLICABLE)
PC642833914
CONTRACTOR'S E-MAIL ADDRESS:
shawn.berger@gmail.com
ARCHITECT (Name)
ARCHITECT'S E-MAIL ADDRESS
ENGINEER Name)
ENGINEER'S E-MAIL ADDRESS:
DESCRIPTION OF
WORK:
Install (1) RPZ (see attached PDF)
PI.D. NUMBER 155 169001(210 1
Address)
Tel.
No.) Address)
7450
Flying Cloud Drive, Eden Prairie N 612)
398-2319 Address)
Address)
0
Tel.
No.) Tel.
No.) Tel.
No.) t1Zzj'
6(
TYPE OF WORK (Please Circle One)
Newl
Addition
Alteration
Repair
Move
Other Plum hi n
ADDITIONAL INFORMATION
Valuation: $4015.00
Construction Type: ,H—=
Occupancy Group:
TYPE OF CONSTRUCTION (Please Circle One)
Cominerciall
Industrial
Institutional
Multi -Family
Other
Square Footage:
of Stories: l nyI
Maximum Occupancy:
Fire Suppression: Yes No LEI
ESTIMATED VALUE OF CONSTRUCTION
MISC. NOTES:
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 the plan that has been approved by the Building Offi-
cial. I agree that any damage caused to public property including but not limited to curb, sidewalk, pub-
lic utilities and signs will be repaired at my expense.
Applicant Signature c zaelvl gd&9ai
Print Name / Title Shawn Berger / Inside Sales & Contract Admin
Date 4.25.22
Approved by Building Official:
Approved by Fire Marshal
Date Approved:
j
7j r'
NA
CITY OF
Monficeflo,
Project Title:
Project Address:
COMMERCIAL & INDUSTRIAL PLAN
SUBMISSION MATRIX
All plans submitted for review must be 24".06" size
Arch D) or smaller. Larger plans will not be accepted.
PROJECT TYPE
Plan Type
a
a rn a
c a o
W U W
Check one x J
Quantity
New Building Construction 2 1 1
Building Addition I 2 1 1
0 I Interior Remodel/Interior Tenant Build -out (no exterior site work) 2 1 1
Interior Remodel/Interior Tenant Build -out (with exterior site work
1 1
e. parking lot improvements/ rovements/exexpansion, utility changes)
2
p p p y
Building Demolition 28 0 I 1
Site work (parking lot expansion, grading/drainage, landscaping, 0 1 1
photometric plans and cut sheets, etc.)
New Exterior Signage (Wall, monument, pylon, etc)
Free-standing signage requires a certificate of survey with location and 2 1 1
setbacks clearly marked
Mechanical (HVAC) permit 2 0 I 1
lumbing permit (more than 5 fixtures must be reviewed by thetate) Is 2° 0 1
IFire Sprinkler or Alarm permit (20 or more heads must be sent to 0 3 1
the state Fire Marshal for review)
SAC square footage based on Met Council's most current guidelines
Applicants identifyshall all use categories and square footage as 1 1
applicable on worksheet provided.
Footnotes:
a. Plumbing projects with more than 5 plumbing fixtures must be submitted to the state for review prior to permit issuance. Basic plumbing
fixture plans maybe required with some building permit applications for calculating fixture counts and SAC charges.
b. "Civil Plans" must include; Certificate of Survey showing proposed location of the building/s, site plan, soil boring locations, utility plan,
exterior lighting plan (with photometric), landscape plan, SWPPP, and I - Office use only'
grading, drainage & erosion control plan. ( Date submitted: s.
Distributed byi
u
Plan review submission matrix v6 October 2020020
N
II
MMC IBACKFLOW PREVENTER TEST FORM
IMEM. 7450 Flying Cloud Drive
Eden Prairie, MN 55344
952-941-7010
Address: City:
19320 Cedar Street I lmo'nticello !
Zip:
155362
Owner/Occupant: Building Name:
lWalmart#3624 lWalmart #3624
Description of Work: Date:
Install 21/2022
Contact Person: Contact Telephone:
System Served: Device Location: Floor #: Room #:
IRO Produce First Produce Make:
Model: Size: Serial #: 1Wilkins
1197.5XL2 1'3/4" ABP8995 Test
Date: Overhaul Date: Install Date: Previous Overhaul Date: 4,
2112022 Vm INITIAL
TEST Check Valve #1 Relief Pressure Check Valve #2 Strainer Closed
3.2 ips, Closed V1 C) None Pressure:
j9.2 ]psi iTight psi 0 Cleaned Test
Passed. YES SUBMIT AS FINAL Describe
1ASSE 1013 RP Repairs:
Final
Test Check Valve #1 Relief Pressure Check Valve #2 0
CLOSED PSI EICLOSED Pressure:
PSI Test
Performed By: Certification Number: ITimothy
A. Nigh BF 064221 Metropolitan
Mechanical Contractors 7450 Flying Cloud Drive Phone:
952-941-7010 Eden Prairie, MN 55345
IN Insert Item
MMC RPZ TEST FORM
Submit