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�Mi 'a Department of Lab <br /> us <br /> 443 Lafayette Road Nort OtL <br /> LABOR & INDUSTRY <br /> St. Plkull <br /> Pho 351 +5068 VAR 2 3 20H <br /> itial Application for Plan Review <br /> www. 1 ..L�J <br /> Please compli ite this application and return it to the Construction Codes and Licensing <br /> Division prior-,o your expected plan review submittal date.This will help us expedite your <br /> RM,W_ k INK or TWE your re9ponses. project while v re determine where you will make application for plan review. <br /> PROJECT TITLE PROJECTED CONSTRUCTION VALUATION <br /> 2011 ROOF REHABILITATION SCHUMANN ELEMENTARY $150,000.00 <br /> ADDRESS ANTICIPATED START DATE <br /> 685 OLD CRYSTAL BAY ROAD JUNE 13, 2011 <br /> CITY OR TO�OMSHIP WHERE LOCATED--PLEASE VERIFY COUNTY <br /> OYVNER(OR STATE AGENCY IF APPLICABLE) CONTACT PERSON <br /> ORONO PUBLIC SCHOOLS-DISTRICT 278 JOHN OSTLUND <br /> ADDRESS PHONE <br /> 685 OLD CRYSTAL BAY ROAD (952)449-8314 <br /> CITY STATE ZIP CODE FAX <br /> LONG LAKE MN 55356 (952)449-8399 <br /> DESIGN FIRM PROJECT CONTACT <br /> SRI CONSULTANTS JOEBOHROD <br /> ADDRESS PHONE <br /> 9220 BASS LAKE ROAD, SUITE 380 (763)533-2727 <br /> CITY STATE ZIP CODE FAX <br /> NEW HOPE MN 55428 (763)533-2772 <br /> Public(state-owned)building paid for by the state or other state agency for: <br /> [_1 National Guard EJ Historical Society [I MN Zoo 7 D.O.T. D.N.R. El Iron Range R <br /> El.M NSCU(State College or U niversity) El State Hospital El State Home El Capitol Complex <br /> Public school district building of$100,000 or more in construction cost <br /> State Licensed Facility licensed as a: <br /> F71 Hospital El Nursing Home Correctional Facility El Boarding Care Home <br /> El Supervised Living Facility Free-standing Outpatient Surgical Center El Residential Hospice <br /> CLASS OF WORK <br /> El New Building Construction El Addition Remodeling El Other, specify <br /> IBC OCCUPANCY CLASSIFICATION(S) I,TYPE OF CONSTRUCTION <br /> EDUCATIONAL OCCUPANCY GROUP E (PE 1 <br /> PROJECT DESCRIPTION <br /> Removal ofexisting modified built-up roof systems including insulation tometal deck and installation ofnew class A <br /> fire-rated asphalt built-up roof system. Reroofing areas totalapproximately 15.ODDsq. ft. <br /> Upon receiving this completed initial application,we will confirm proper jurisdiction for the project, assign a project number,and determine <br /> who will do plan review and Inspections.Within a few days we will notify you In writing of the project number,where to submit your <br /> documents for review,and how Inspections will be handled. If delegated to the municipality,you will need to follow their procedures and fee <br /> schedule. Otherwise our standard application process will need to be followed. <br /> I completed the information on this application and understand fhatit does not authorize the start of construction. <br /> APPLICANT NAME(PRINT) PPL T E DATE <br /> JOEBOHROD 3/23/11 <br /> ThIs material can be made available In different forms,_�Ilch AR I=Ljrint Braille or on a tape. T o request,call 1-800-342-5354(DIAL-DLI)Voice or <br /> TDD(651)297-4198. <br /> BCS 01(7/10) <br />