2024-02689CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS 9872 HART BLVD
PIN : 155117002010
LEGAL DESC RIVER VIEW SQUARE
LOT 001 BLOCK 002
PERMIT TYPE : BUILDING
PROPERTY TYPE COMMERCIAL
CONSTRUCTION TYPE SIDING & WINDOWS & OR DOORS
VALUATION : $ 13,700.00
NOTE: REPLACE (2) DAMAGED WINDOWS.
REPAIR GLASS IN (2) WINDOWS.
REMOVE AND REPLACE SIDING AROUND WINDOWS.
TOUCH UP DAMAGED INTERIOR SHEETROCK AROUND WINDOWS THAT ARE TO BE REPLACED.
APPLICANT
DELTA MODULAR CONSTRUCTION
6757 KARMEN AVE NE
ALBERTVILLE, MN 55301-
612) 760-2072
OWNER
MONTICELLO SR HOUSING OWNER LLC
17550 HAMLOCK AVENUE
LAKEVILLE, MN 55044-
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 2 4- 0 2 6 8 9
DATE ISSUED: 01/06/2025
Permit #: 2024-02689
BUILDING PERMIT FEE
STATE SURCHARGE, BLDG VAL
TOTAL
Payment(s)
CREDIT CARD 3687
251.49
6.85
258.34
258.34
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CI I y <- EPermit No.Monticeflo
BUILDING S IEETY ' k
COMMERCIAL / INDUSTRIAL BUILDING PERMIT APPLICATION
505 Walnut Street, Suite #1 Monticello, MN 55362 Ph: 763-295-3060
buildingdepartment@ci.monticello.mn.us
SITE ADDRESS
9872 Hart Blvd, Monticello MN 55362
LEGAL DESCRIPTION
LOT BLOCK
PLAT
OWNER (Name)
Willows Landing Senior Living
OWNER'S E-MAIL ADDRESS:
mhoagberg@headwatersdevelopment.com
CONTRACTOR (Name)
Delta Modular Construction
CONTRACTOR'S LICENSE NUMBER (IF APPLICABLE)
I R780837
CONTRACTOR'S E-MAIL ADDRESS:
ds@delta-modular.com
ARCHITECT (Name)
N/A
ARCHITECT'S E-MAIL ADDRESS
N/A
ENGINEER (Name)
N/A
ENGINEER`S E-MAIL ADDRESS:
N/A
PID. NUMBER
ZONED
Address)
9872 Hart Blvd, Monticello MN 55362
Tel. No.)
612) 438-2727
Address)
6757 Karmen Ave NE, Albertville, MN
651) 328-0749
Address)
N/A
N/A
Address)
N/A
Tel. No.)
Tel. No.)
Tel. No.)
DESCRIPTION OF
WORK:
Replace (2) damaged windows. Repair glass in (2) windows. Remove and replace
siding around windows. Touch up damaged interior sheetrock around windows that
cai C lu be I Vp1m;Ud.
TYPE OF WORK (Please Circle One)
New
Addition
Alteration
Repair
Move
Other
ADDITIONAL INFORMATION
Valuation: $13700
Construction Type:
Occupancy Group:
Square Footage:
of Stories:
Commercial
N/A
N/A
3 stories
Maximum Occupancy:
N/A
Fire Suppression: Yes
TYPE OF CONSTRUCTION (Please Circle One)
tommerciall Senior Living Facility
Industrial
Institutional
Multi -Family
Other
No 10
ESTIMATED VALUE OF CONSTRUCTION
MISC. NOTES:
Replace (2) Windows
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 /' "
Print Name / Title Dylan Scarpo roject Manager
Date 11 /27/2024
Approved by Building Official:
Approved by Fire Marshal
Date Approved: / Total Permit Fee: $
IZ Y Of
COMMERCIAL & INDUSTRIAL PLANiceflo
SUBMISSION MATRIX
Project Title: Willows Landing Window Repair Plan Type
Project Address: 9872 Hart Blvd, Monticello MN 55362 a
All plans submitted for review must be 24"06" size a
Arch D) or smaller. Larger plans will not be accepted.
a
a
PROJECT TYPE a o
r,
f
U
U W
Check one
Quantity
New Building Construction 1 1
Building Addition I 2 1 1
Interior Remodel/Interior Tenant Build -out (no exterior site work) I 2 1 1
Interior Remodel/Interior Tenant Build -out (with exterior site work
1 1
e. parking lot improvements/ rovements/exexpansion, utility changes)
2
g• P g P P Y
Building Demolition 2a 0 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-standingsi na a requires a certi icate o survey with location andggqffy 2 1 1
setbacks clearly marked
Mechanical (HVAC) permit I 2 0 1
Els28Plumbingpermit (more than 5 fixtures must be reviewed by the 0 1
state)
Fire 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 shall identify 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 may be 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 Office use only
grading, drainage & erosion control plan. Date submitted:
Distributed by:
Plan review submission matrix v6 October 2020020