2012-00601CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS 406 7TH ST E STE 400
PIN 155029002070
LEGAL DESC LAURING HILLSIDE TERRACE
LOT 007 BLOCK 002
PERMIT TYPE FIRE SAFETY
PROPERTY TYPE COMMERCIAL
I
CONSTRUCTION TYPE FIRE SUPPRESSION
I
VALUATION 700.00
NOTF: RELOCATE F.D.C. & ADD 1 SPRINKLER HEAD IN NEW RESTROOM.
APPLICANT
BRE%H-ZENZEN
8053 STERLING DRIVE
SUITE 101
ST JOSEPH, MN 56374-
320) 363-0900
W
ALLIED PROPERTY MANAGEMENT
20125 COMMERCIAL BLVD. #1000
ROGERS, MN 55374-
I 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 curl; sidewalk,
public utilities and signs will be repaired at my expense
Applicant
Date!
Bldg.Ofcial Date
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2 0 1 2— 0 0 6 0 1*
DATE ISSUED: 10/29/2012
BUILDING PERMIT FEE 31.01
PLAN REVIEW 20.16
STATE SURCHARGE, OTHER VAL 5.00
TOTAL 56.17
PAID WITH CHECK # 8495
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
MONTICELLO
DEVELOPMENT SERVICES
BUILDING INSPECTIONS
505 WALNUT STREET, SUITE I
MONTICELLO, MN 55362
City Hall (763) 295-2711
PERMIT # 1-7,—OCL60l,
PID #
Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING." .11 RMIT APPLICATION.r_ x iv
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: 40(p MAST
LEGAL: Lot Block Plat
ZONED
Property Owner Name: T: 2,-V 'b L hs.
k
Phone:
Address: City: State: Zip:
Contractor Name: - —_ T% W-L, Phone:
State License #:
Address: pS3 Smt u Nip, bo , S,-,rrL— to t City: 'or. " kk State: NAM Zip: %G3-ty
Eng./Architect Name:
Address:
Plumber Name:
Address:
Mechanical Name:
Address:
Tvpe of Work
New
Addition
Alteration
Repair
Move
Other
D script'on of work: '(
City:
City:
City:
Tvue of Construction
Single Family
Duplex
Multi -.Family
Con unercial
Industrial
Residential Garage
Other
fheo
Phone:
Phone:
Phone:
State: Zip:
State: Zip:
State: Zip:
Building Information
Use of building
of stories
Floor area sq. ft.
Estimated value
of construction S '1000!!-
Is this a "Master Plan" per AIN Rule
1300.0160 Subp.6? Yes IV No
FOR ROOF & SIDING PERMITS,
PLEASE PROVIDE # OF SQUARES
OF SHINGLES &/OR SIDING.
I hereby apply for a pennit for construction as described and acknowledge that the infonnation I have provided above is complete and accurate. I
agree that the work will be conducted in confonnance with the ordinances of the City of Monticello and with the Laws of the State of Wnnesota;
and that I understand that this application is not a pennit and that the work is not to start without a permit. I further 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.
0 v SEE BACK FOR .PLUMBING
t 0 km i t2 AND MECHANICAL INFO.
Applicant Signatttr Application Date
APPLICANT: Please shorn fixtures that are applicable.
Fire Suppression : (if applicable) Plumbing, (if applicable) Hechanical. (if applicable)
tio. Fixture Tvpe
Sprinkler Heads
Other/Special FS Device
Fire Alarm: (if applicable)
No. Fixture Tvae
f# ofDevices
Other
No. Fixture Tvpe
Water Closet (toilet)
Bathtub
Lavatory (wash burin)
Shower
Kitchen Sink
Dishwasher
Laundry Tub
Clothes Rasher
lVater ITeater
Urinal
Drinking Fountain
Floor Drain
Slop Sink
Hydrants
TOTAL
S9 Per Firtare)
No. Fixture Tvpe
Furnace
Gas Meter
Range Hood
Gas Ra rge
Mater Heater
Air Conditioning
tllech. Fireplace
Bathroom(s) Exhaust Fa r
Air Exchanger
Dryer
Gas Opening sa/o Fixture
TOTAL
S9 Per FLrtttre)
FOR CITY USE ONLY,
Tree Ordinance.Handout Yes No
FEES: Other Handouts Yes No
Bldg. Pennit
Plan Review
State Surcharge
Bldg. Total
Plrng. Pennit
Fixtures ADDITIONAL INFORNIATION:
Surcharge Valuation:
Plmb. Total Construction Type:
lblecli..Permit Occupancy Group:
Fixtures Division:
Surcharge I Square Footage:
Mech. Total 4 of Stories:
Sewer Access of Residential Units:
Water Access Maximum Occupancy:
Water Meter Fire Sprinklers: U Yes F 1 Nop
Meter Sales Tax Off -Street Parking Covered:
Meter Total Off -Street Parking Uncovered:
Sew & Water Pennit
Trunk Water
Trunk Sanitary SeNver Building 0fficial" L. _O/Z//-Z,
Trunk Stonn Sewer BPT: j / 1
Lift Station
TOTAL FEES:
P0 r-
8 FD C
0 ox --I
0
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m01
In al Jill
T 0