HomeMy WebLinkAbout2014-01467 - addn/remodel/repair CITY OF ORONO * Z 0 1 4 - 0 1 4 6 7 *
' 2750 KELLEY PARKWAY DATE ISSUED: OU05/2015
� ORONO, MN 55356-
952 249-4600 FAX: (952 249-4616
ADDRESS : 1350 REST POINT LA
PIN : 07-117-23-32-0039
LEGAL DESC : SUBD REST POINT PARK LAKE MTKA
: LOT 021 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIV[TY : 434-RESIDENTIAL
VALUATION : $ 8,755.00
NOTE: CRAWL SPACE ENCAPSULATION
APPLICANT PERMIT FEE SCHEDULE 177.00
PLAN REVIEW 115.05
COMPLETE BASEMENT SYSTEMS STATE SURCHARGE(VALUATION) 4.38
54004 LOREN DRIVE
MANKATO, MN 56001- MAIL-[N FEE 2.00
(507)387-0500 TOTAL 298.43
Minnesota State License#: BUIL-143377 Payment(s)
CHECK 021555 298.43
OWNER
HOXIE,MIKE
1350 REST POINT LA
MOLTND, MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according[o
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any[ime for due cause. �
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Applicant Permitee Signature � Date Issued By Signat e Date
Dec 17 14 12: 50p Victor & Kathy Barke 507-625-3343 p. 2
City of �rono
Building Permit Application for Maintenance / Rep{acement / Renovationl� � i j s�
(N o s t r u c t u r a l e x p a n s i o n. O n l y w i ndows, doors, siding, re-roof, etc.)
,: O,`
Mailing Address: Permit number i��� �L'� �'� `-�
/ Q PO Box 66 �
� �Q Crystal Bay,MN 55323-0066 Date received: r� Z �
F�M�� ,�r�
Received by: L—�'
StreetAddress� �.r /oJ�
-� � 2750 Kelley Parkway Plan reviewfee: ��� ~ !i��'"-``�'` -
�^ � Orono,MN 55356 -s� � 3
\F s F���L'� Total Fee: '���(�;,
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
7his application form must be completed in full and all required information must be submitted.
Incomplete application�will be returned. (Please print)
GENERAL INFORMATION: , � ' �
Job Site Address: �� �'� �� � '�>� � '1'�U� �
p y ❑Yes �No
Will this be a Parade of Homes, Remodele s Showcase Home or ot e Dis la Home?
If yes,a special event permit is required with Police DepaRment and City Council approva!60 days pnor to the event Shuttfe bus service wilf be
required un(ess applicant demonstrates suilicient on-site parking is available. Non-permrtted events wil!not be allowed.
CONTRACTOR/APPLICANT INFORM{A� TION:
��`,�� U C1,a;10 `�"1�`�'1 �i-�4��^m.�� —
Name: �c- - -
Expiration Qate: - 3�-
State License# � ��� �J Expiration Date: -1 p
Lead Certification Number: �'`('�ti `p�(�t,�l ' - J
(for work on homes Ehat were constructed prior!0 1978 ,� �;� _ � ��J
Phone: (cell) (oifice) C tZ � � � � �
City: "`�'�6,Y'�'`Gl.t[��P- � �
Mailing Address: ��"r>rJ�� . !'� "� L�'`� -
Contact Person: - 1F_ Applicant is: on rac o / Homeowner (Circle One)
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Email and/or Fax: � ,�; r � �a � t,^�.��.�;�' ' � ' �M�l 0^n"S- ,C`_�'���---
PROPERTY OWNER INFORMATION:
Name: 1��\1 � X �L
( v)� _ � - '� ' ��`".
Add ess a ')j�V �� . . " *z tn r , �� City: �i r Cst,'1�_(�. ZIP: ��.��D��"
Email andlor Fax:
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PROJECT INFORMATION: Overall ro'ect description: � .,4_t ��J L��� �-- �"�"'
Type of Project: Any earth movem nt may also require
fJICWD review&permits�
❑Door(s) ❑Remodel ❑Fire Darnage
Minnehaha Creek Watershed District(MCWD)
❑Re-roof,asphalt �Kepair ❑Storm Damage �gzp2 Minnetonka 61vd
Restoration ❑Water Damage Deephaven,MN 55391
❑Re-roof,cedar ❑ phone: 952-471-0590
❑Re-roof,other(specify) ❑Siding ❑Other(specify} Fax: 952-471-0882
❑Window(s) (�(_Lt9'J�� �'��'�' www minnehahacreek.orq
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Estimated Construction Valuation of Project(exctuding land) $
APPLICANT ACKNOWLEDGEMEN7:
. Agrees to provide all information required or requested by the Buifding Department;
Certifes that the information supplied is true and correct to the best of hislher knowledge. The applicant recognizes that they are
• solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no afternative but to
reject it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified by State law as either private or
confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data.
Confidential data is inf ation which generally cannot be given to either the public or the subject of the data. Our purpose and
intended use of this i form`�tion is to annu Ily update our records and records of other governmental agencies required by law. If
you refuse to su 1 e inQormation,the ap icatro ma not be issued.
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Applicant's Signature: r 9�l���- � � Date: T �
Owner's Signature: Qate:
Last Updated:03/06I2013
Dec 17 14 12: 50p Victor a Kathy Barke 507-625-3343 p. 3
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Complete Basamant Systems
� Eric Hazelton ' `.� ����'b
• _ Yow 8asemenf Professional ,��gj���mg�.� c�-
� www. �(�
(800)638-5285(5Q7)5141807 ��,��7�,� �,� r �, +�� �1� �
� saaoe t�,or. ��
Mankaro.MN 5500� fovrchtionr1cpaihRodbmlitig000n
FAX:(507)625-3343
�mm, Lic#40143377
� PROPOSAL DATE: 10/31/2014 EMAIL:
���-s�`��- z33Y
� SUBM�TTED T0: Mlke HOXiB � MOME: - �
� qppREss: 1350 R�t PofM Lane Orono MN 55384 WORK: = -`
JOB�OCATION: 1350 Rest PoiM Lane Orono MN SS364 �� _ .-
FAX: - � `
System Features ��a ��
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— --�—..—_..— -- -— �axms—....ouunt '-------- I - -- /f�
!CleanSpece I i454_I I cape .._.—____—._.—. .._.�..__I I APPROX INST ON DAT : ���
-.--- - - — — PPROX.C MPLETIO :
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j$eN11AEI'efgy _ __. ._.—_ .i � . _—_ .� _._.� L....—._..._ �wrr�eramalewuaem�wo�__ ...---�- '---
--- -- _
F UlBmate Energy Savings I �RainChu6e � �..
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wmp P'rers 8 R`ainCh-+—EZ--- _ ---i.--- rY�
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-- . .__. .—...—.. -- .. �. �----
�Orainage Mathng 1040 LawnScepe Fxt . 1
----
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,� nsa�e veN covers -. �� .._.T_.� * �
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The �+tL
IW -- ___ __ -� Smarl J Header(LF� � � �.�
�T �-•---• ._.---�I---J Pemiit� -- —�--- � ' ���,�-���
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r � �ProY F 2'(SF) ----- -I .
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� R oval ---'-- - - � I Santa Fe lmpact .—_ �
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�Reg tar D2ma9e �_ Santa Fe Ue —__— —_ ---- � � s�!►��►`� � I
�sm -Sump --- — — � � I 3aMa Fe Edge II ----�_. � O O � � �
' �---' ---- - "�
I T e - _ f-- Santa FelElement �-�--
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1__ � � ..--- --- — ___.�._ . We Propose
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..; ru rsia melefial a Wwr-oornqale�n a�da��wdl,anwa I
I��� _ '�� IspeciGcetions,fatnosumd �
I fully understand and accept the transferable warranty provided,which covers only the � �
I M Basement Price $ �•00 �
arees of ihebasement addressed and does nol oover water damage.PaAial Qerimeter y �
s y stems ca rt y a limited warranty.Sump pumps are cov�pred by a separate manufacturer � MyCraw{space Price $ $755.00 i �•Ty
y fini �s 4 Total Contract Price $ 8755.00 ��
wartanty,Installation of ihe s stem does rat lndude painGng, shed carpentry,extendi
disCharge lines,81ecVical work,or replacement of floor�Lile or carpeting.Contractor cannot �De�t Requued 40 % $ 350 ' O
be responsible for frozen discharge lines without an loecivard,condensation,damp spot �i Deposit Paid $ 0.00
discoloratlon,water once pumped from house,window�ve0 fiooding,or fuel lenks or Gnes. Oue Upon Insfallation $ 8755.00 �
Customer shall grant contractor a 60 day right to remedy arry problem after reported. I_______—.._—_..---____-.- �
Momeowner responsible for moving objects away irom alls and back again.Some dust A��S����v�np X _
slwUltl be expectetl from work.Payments to be made i�full upon complelion.All material Is raaled al AoorMrall lomt was recortunended�--
gua�anteed to be as specified.NI work to be completedIxcording to the standard Ham�ner is aware ot servioe X �_,___
practices.Any alleretian from above specifical"ans will tie executeU only upon wrttten �"a'"ien""`Y?r°orer"
orders,and will become an extra charge.All agreement contingent upon accidents or A second sump was recommended • X ___
defays beyond our conirol.Our workers are futly covere�by workmen's Compensation q Radon system was�mmended x__ ____
Insurance.Homeowner assumes all responsibifity for mages due 10 hreakape of any
hidden fueUu6lity service Il�es,though w will do our�t to evoid such dama9e•A�� rppe of wal�: Bbdc
proposals based pnman BO rs plion qf problem.Warranty does not cover �tl��p finish:
��r��•�• n hy us i�not accePted within 120 days.
. .—.... �����.�/JEx�dng Noor Tinish: iAD
Sellers Signahi . _-Date -- � / Diso►ur9e line fangth away hom h O
� --- -----.— ._...._____ _..__. �.�d' ..s and seP�te wartaMy ere
Accaptence of Proposel-The above .specifkab
salbfec0ory and xe herebya�pted Y are fhor¢ed fa da e wmk 88 speCifled.Paytnent wi1 he
��adg as pulined above tdON ST EMS UST BE PAID N FULL AND ARE NON EFU DABIE.
:�
guye�g 5(gnature: Date I
Buy9r's Signature' I Date
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PAGE 1 OF 5
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va Fax Cover This is a confidential message, intended solely for the person to whom
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Manl:ato,MN
56001
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Dec 17 14 12: 51p Victor a Kathy Harke 507-625-3343 p. 4
�os wcnnonc 1330 Rest Point Lane Orono,MN 55364
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t.Install SmarlDDrai�n cxaw�l�ce nde�r CieanS�pace I ner�.'n4.WraP the Ibottam of pie� 5.Permit a�s 8r�d su&t,lonstall SaMa Fe Elem�en�. 3.
Instafl CleanBpaee �90 I
CONTRACTOR WILI:
CUSTOMER WILL:
NOTES:
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PAGE 2 OF 5
Dec 17 14 12: 52p Victor & Kathy Barke 507-625-3343 p. 5
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� � SGS U.S. �'esting Company fnc.�—� ;; ,-r�•y�r'r;_.,�;; y .
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5��5 Telegraph Raad m Los Angeles, CA 90040 • Tel: 3Z3-838-7fi00 � Fax: 323-722-8251 �
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C�lEfVT: BASEMENT SYSTEMS, INC, y
fi0 Silvermine Road N
Seymour, CT 06483 °
Larry Janesky �,
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e est Repoct i�o: '168829 Date: • July 12, 2002 ^
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S63FViPLE pD: The Clie�� submitted and identified the foflowing test material as Cleanspace °
Crawl Space Liner. �,
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�ATi. OF RECElPT: Entered into SGS USTC samp(e tracking system on May 2.9, 2002 as STN o
34885. �,
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R�S s 6NG PERIOD: July 3, 20p2. o
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����C3RBZAT1081l: CEient's Purchase Order Na. 7 24000. o
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��S►.REQUESTED: Perfnrm standard flame spread and smoke density developed cJassi�ication tests on y
fhe sample supptied by�the Client in accordance with ASTM Designation E84-01, o
� • "Standard Method of Test for Surface Buming:Cha�aGterisiics. ot8e,ti�ding Materials". N
The foregoing iest proc�dure is comparable,ta UI�723,.ANSI/NFPA No. 255, and y
UBC No. 8-1. . � � o
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�ES r t�ESULTS: Flame S read Smoke Densitv . tl�
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1� �� Signed for and on behaff of N
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� .SGS U.S. Tesfing Company Inc. tl
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Brian Orega � ' ' . ''� N
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Test Technicia " - -: - . .,. , . , ._.._ ,�_�1� ._.. : ....,..-_.�r: , eg.Sanask+y;�� . : , H
� _ .. ,_ . _._ .. , . - . ,- . �r•,<�..,:... � . -Supervisqr..Fire��TecfinaFngy . . . "
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Titis report is issued by SGS U:S. Tasting Company Ina urider it& Genarai Conditions for Testin0 Servicas �copy evaiisble upon raquest), SGS �°�n
iJ.s, TesDng's responsibility undar this report is Iimitad to p�ovan nagliBence and will in no ease ba more than the emount of tha tasti�g fees. �
=zcept by special arrangament,sem�les ere not retainad by SGS l�.s.TasTing tor more then 30 days. The resttlts shown on this test report refer y
�nly to the samplatsy tested unless otherwise siatad, undar the conditions agraed upon. Artyona rolying on this report shoutd undarstnnd sfl of ,°,
':he detzils of the engagement. Neither rhe narne, seals, marks na�r irtstgnia of SGS U.S,Testing mey be used in eny advertising or prornotional �
�sterials wi:hout tha prior written approval of SGS U.S. Tesiing.� The test repott cannot be reproducad, exeept in tull, wiif�out prior writtan 1°
�ermission oi S65 LJ.S.Testing Company Inc, . ,
;:SoSGSaSGSoSGS•SGS�SGS•SGS�SGS�SGS•CGS• Member of the SGS Gro�p{Socidi�Gbnetele da Survaillance) `"
SGs•5G5�SG^rsGS•SGS�SGS�SGS� G9SGS�SG95GS�SGSSGS�SGS�SG5�SGS�SGS�SGS•SGS�SGS•SGS�SGS�SGS�SGS�SGS•SGS�SGS�a
Dec 17 14 12: 52p Victor & Kath� Harke 507-625-3343 p. 6
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� ��� SGS U.S. T�sting Gompany tnc. Report No.: 168829 0
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1 Date: 3uf1! 12, 2oa2 �
' CLIEM�: BASEMENT SYSTEMS, INC. Page: 2 of 4 %
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o ??�EPARATION AND CONDiTIONING: The sample material was submitted in one piece 24" wide by 24' ;
�; long. 3he sampie was supported during testing by 2" hexagonaf inesh poultry netting running #he o
� lzngth of the test chamber and Y4"round metal rods placed at two foot intervals across the width of the o
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� Prior to testing, the specimen was pfaced in the.cnnd�#iot�in�. roem:.(tjr,'air.tairrec� a* ?3.� ± 5° F and a %
a relative humidity of 50 �5%1 and aHowed to reach moisture equilibrium. %
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� St9IVV�MARY Q� A5TM E$4 RESUL7S: Because of the possible variations in reproducibility, the results q
; are acljusted to�ehe nearest figure divisibae by 15. a
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� �AGIIIPLE FIAME , SMOKE o
n �DEi�T1FICATION SP�EAp DENS(TY y
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° Cfeanspace 10 � 105 m
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; �n order to obtain the Flame Spread Classifica'Ition, the above results shouid be compared to the o
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; ;ollowing tabfe: . "'
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; � ��-PA CLASS UBC CLASS FLAMEI SPREAD o
; A I 0 thraugh 25 ;
� g Il 26 thr�ugh 75 �
; � li1 76 through 200 �
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� ��:��[N� co��� a��: � � � � �
� 1. National �ire Protection Association, ANSIJNFPA No. 101, "L'tfe Safety Code", 1994 Edition. N
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� 2. Uniform Buifding Code, 1994 Edition, Chapter 8, Interior Finishes, Sections 801-807. N
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Mambor o4 tha SGS Group(Socibte Ger+�rsle de Sunreiilencel N
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Dec 17 14 12: 53p Victor a Kathy Harke 507-625-3343 p. 7
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� SOS U.S. Testing Company Inc. RepoR No.; 168829 y
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Date: .futy 1`, 2002 w
CLIENT: BRSEMEi1[T SYSTEMS, INC. Page: 3 of 4 °
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= 8� TEST DATA SHEET: . y
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C�i��i:_Basement Svstems. Inc. DA7E: 7/310� °
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SAMf�LE: Cleanspace Crawl Soace Liner. ' N
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