HomeMy WebLinkAbout1997-008851 - inground pool PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 F:t_;1[ D
_ 3vt
Crystal Bay, Minnesota 55323 Permit Number:
_ :;
(612) 473-7357 Date Issued: /o-,/q7
SITE ADDRESS:
WATERTOWN RD
H �
DESCRIPTION:
a
ui idling Permit 'Type SF-AC STRtjC•,URE �
E-:u�i l d i ng Wor ik, Type F'C:C-CE.. �
cellsus
REMARKS:
FEE SUMMARY: {
Plan Review 4.
CONTRACTOR: OWNER:
:HE, 1�E t' I�k E H I EI Y RE WEE TS PERM X S T Via ; PEt L �� T
"�F`E W1 AID °fiC�RE~�t Tn Dl t .E 4� ��1 ;;, � ' . E W TN A.t. ; 3 , tl=
APPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE
s�
T Total Fee: $ �11a Date Received: / 577
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: ��� 1��� cj� ZIP:
NAME OF OWNER: > i('9_ PHONE: (home) 'S�Q6
-� (work)
MAILING ADDRESS: CITY: ZIP: 3S
CONTRACTOR: ��\` PHONE:
CONTACT PERSON: , MOBILE/PAGER:
MAILING ADDRESS c e 1 CITY: ZIP: C
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): xQ4 'S K�n L &V-\
\ F
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ( ajmc� )
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNAT ATE:
NOTE! Parade Qf Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
6
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, political subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data:and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals, and whether it is classified as public, private or confidential. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown the data without any charge to him and,'if he desires, shall be informed of the content
and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making, certifying,and compiling the copies.
The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
c, L. �i�C��—k
Fi t Middle Last
A4drjess
t
City State Zip Phone
I understand my rights as stated above.
Sign
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESSOR LEGAL: 0A5—9Q LU A /
PID:
DESCRIPTION OF WORK:
ZONING REVIEW BY: L DATE APPROVED:
BUILDING REVIEW BY: ny DATE APPROVED:
------------------------------------------------------------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes z/ No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes c/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: 2Q• 1(�
Fire Department: (,p,u Post Office: School District: ()AxA,,O
Lot Area: Sq.ft. ,o Acres Width Depth
Survey Submitted: Yes kC No Date of Survey:
Proposed Setbacks:
Front (Lake): 118 � Right Side:
Rear (Street): Left Side: ( &V 4
Adjacent Structures: 10 Wetland: N (A
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
- Avg. Setback: Bluff Setback:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
BUILDING REVIEW CHECK LIST
UBC: CONSTRUCTION TYPE:
Sq Footage S Per Sq Ftg
Basement x =
1st Floor x =
N 2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 12-,oic
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
9 Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_e- Final Grading/Filling Electrical (State Permit)
Other
----------------------------------------------------------------------
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
27
STATE OF MINNESOTIi
DEPARTMENT OF COM
'. MERCE STATE OF MN pEPT
.,
133 East Seventh 3t OF COMMERCE
Pw1.MN SS 101 133 Easseventh
t
. ;' (612)296-6319
St.Paul,W,5.51
0
BUII�IIJ(}COR
.6319
(61 Z)296
II3#S023 BUILD
Il�ft}CONTRA(►
BVIL,DE>Z �• .
IZ? 5023
CORPORATION
Expires: ,03/31/1995 BVIZ,Dgt
CORPORATION
VIlZC}INI MULVANEI'
7HrsCdue
13y 3!31!98.
CUSTOM POOL.9 II�TO:
Expires Q3l31l1998
8960 EXCELgIOR BLVD VIRGMT 4.MUI.VgNEy
HOPKIIdS MN 33343-0000
7 Hrs CE�e by 313.I/98
DBA.CUMM POOLS INC
Asa . 8960 EXCELSIOR BLVD a,
33
HOPICINB W.55341.
�s 43 OQOQ;;
2C)rV o
Features (cone.) Outline Dimensions Media Kiss
• O-ring seals and hand tightened fit- Syst'em3_Ssnd System 3 filters can change from one
tings have replaced gaskets and Cat.No. AC 0 E media type to another within minutes,
thread sealants at all bulkhead,drain -- --- - in many cases without disturbing any
and gauge port locations. S7S50 28 5' 42' 7 36' 53.5' plumbing.Kit includes complete inter-
- Top}xort allows for in-tank chemical nal assemblies,bulkhead fittings,oper-
treatment of media.Bushing and 0- A-width,8.height:C=number old nips 0-area ating labels and manual.Consult
ring design helps prevent tank dam- (width)needed to take off clamps,E=area(height)needed customerservicefor information
age.
lo remove top hall of tank
• 'Tank base is integrally molded.
Incorporates leveling pads and FiiterOrdering lnforn�ation
mounting holes to facilitate all instal-
lations. 0
Catalog Fitter Ship Wt. Carlon
• Dramatically oversized drains are ori- No. Area (lbs.) Size
ented for both side and bottom access. ..
(D-ring sealing plugs may be used as is a S7S50 ?4 sq.It.
or adapted for all piping and valving 4 SSS70 3.4 sq.Il.
applications.Combination sand-or- •'As we go to press,this information is nol yet available.
water drain empties tank in moments. E
Q E
Materials and Design
• Tank t'rflt INLET ^
Glass reinforced thermoplastic Dura- ~'T�
Glas.Proprietary blend contains car- t'1r `•
bon black for maximum outdoor rsu-utt
aging resistance. UNION CONNECTIONS.
• Clamps
Plated and polished stainless steel.
Designed with hand secured knob
and stud assemblies. Filter Sizing
• piping Connections
Through-tank bulkhead fittings fea- Catalog Maximum Pool Size Pool Size Port
ture full 2"diameter clear flow.Hand Number Flow 8 hr.rate' 6 hr.rata• Size_
secured against O-ring seals,the bulk- ;7S50 48 GPM 17,280-23.000 13,1]00 17,300 2'
head fittings allow for union style SBS70 68 GPM 24.480-32.640 19.000-24.489 2'
connection to any of the Sta-Rite slide
or multi-position valves. Based on 15 to 20 GPM recommended now rare range.
• Tank Base
Integrally molded with tank.Design
incorporak s leveling pads and
mounting holes. Accessory Ordering Information
• Air Bleed
Contanis internal automatic air bleed, Catalog Valve Valve Body Valve Port Ship Wt.
as well as top mounted air bleed at Number Type Material Size (lbs.)
gauge port assembly. WC212-134P slide ABS 2' 4
• Operating Limits WC212-136D slide bronze 2" 11
Designed for maximum continual WC212-144P mulliport ABS 2' 6
working pressure of 50 psi.Water
tempera lure maximum 105'F.
Fcxm.No 54'1PS (Rev 2/92) Q 1991 Sla•Rile Indusiries,Inc. sia-Rile/a WICOR can
Ordering Information Dura-Glas HIL"'
High SF Nom. Low SF Nom. Port Size(FPT)
Model HP Model HP Max.BHP Volts Suction Discharge Wt.(lbs) ,accessory
Dura-G/as
P2RA5CL 1/2 .65 115/230 1-1/2' 1-1/2' 32 Ordering Information
P2R5CL 1/2 P2RA5DL 3/4 .95 115/230 1-1/2" 1-1/2' 35
P2R5DL 3/4 P2RA5EL 1 1.25 115/230 1-1/2' 1-1/2' 37 Suc. Wt.
P2R5EL 1 P2RA5FL 1-1/2 1.65 115/230 1-1/2' 1-1/2' 43 Cat No. Description Size (lbs)
Dura-Glas 11 Pkg.115 5'Dura-Glas Trap
P4R6EL 1 P4RA6FL 1-1/2 1.65 230 2" 2" 43 w/Basket 1-1/2" 3
P4R6FL 1-1/2 P4RA6GL 2 2.2 230 2" 2" 49 Pkg.118 2'x1-1/2'Dura-Glas
Dura-Glas HIL Suction Adapter 2' 1
P2RA5YEL 1-1/5 1.25 230 1-1/2' 1-1/2' 41 U79-11 Lid wrench for 5'or
P2RA5YFL 1-1/2-1/4 1.65 230 1-1/2' 1-1/2' 46 6"trap lids — 1
P2RA5YGL' 2-1/3 2.20 230 1-1/2" 1-1/2' 47 11201-0154-10 PVC Union 2'Male
P4RA6YFL` 1-1/2-1/4 1.65 230 1-1/2" 1/1-2' 46 NPT x 2'Female Slip
P4RA6YGL' 2-1/3 2.20 230 2" 1-1/2' 47 10 pack(for"P4"only) — 10
'Capacitor Start/Capacitor Run Motor
"200 and 575 volt models available,consult factory.
Outline Dimensions
/ Dura-Glas "PZR"Series
(\ Catalog Number Dimension A
High Service Factor Low Service Factor �= Iw
P2RA5CL 15-11/16' ------- j- — 11
YO
o
u1/+
P2R5CL P2RA5DL 16-5/16' o o \ i
1usn0u
P2R5DL P2RA5EL 16-5/16" 1(
spa nllrsutanrivr.
P2R5EL P2RA5FL 17-7/16" BA lel/1�Bn 11/I�:L�R
s 1 All dimensions
sum a1�r�� shown in inches
B BiT
t Brr o60weE
Dura-Glas 11"P4R"Series Ir
tlnsuolal
Catalog Number Dimension A
High Service Factor Low Service Factor
BsvI
133/1
P4R6EL P4RA6FL 27-1/8' — — — —
- -7
0 o I 10Y1
P4R6FL P4RA6GL 27-1/2' = v Bla
i
I711M BIAB 71d-�
1/2al2xaa III/+
1 All dimensions
111/1 shown in inches
C INSOMM 11/r01 11A6 1-1 1RY SIIfIY1N 11?Irf
Dura-Glas HIL"P2RA"Series
Catalog Number Dimension A 'v"
High Service Factor Low Service Factor 1 IBYI I- _ I+54
P2RA5YEL 17-11/16i—
P2RA5YFL 1.8-3/8 0 \ 1vt 1+BYINO
P2RA5YGL 18-3/8 1 ( A
All
Note: nrsurnatvr.
See IllustraP4RA6YFL 27-1/8
tion t3} P4RA6YGL 27-1/2 5 n— 11 Bn1 shown n nches
n
"NO DIVING"LABELS MUST BE INSTALLED vB ri "• " 1
AROUND SHALLOW END OF POOL IN Neer 5r ds.
ACCORDANCE WITH LINER MFG.DIRECTIONS.
CORNER DETAIL
j - -- PANEL
V
CORNER
FILLER
A X
12"
J 1
r
I,
rr -90 DEG CORNER
U
y 3/8 X I'NUT a BOLT
r
=_ % !� RIM COPING
OPTIONAL STEP CONCRETE
COPING
POOL SIZES �• '::" •�. ':� `
I•-33"�-POINT'A' DIM.
18X36 20X40
1�WATER — A 16'-0' 18'-0" 20'-O' TEK SCREW
PANEL
LINE B 32'-0' 36'-0' 40'-0"
MIN. p 2'10'
MIN. MIN. � 42" C 87-0' B'-O' 8'-0" �
r I_}_ _1 D 3'-4' 3'-4- 3'-4'
E 4'-O" 4'-0' 4'-0'
UNDISTURBED F 6'-O' 8'-0"
EARTH G 14'-O' 14'-0' 14'-0-O.
2"SAND OR H 8'-O' 10'- 0 14'-0 ,
VERMICULITE I 4'-0' 4'-O' 4'-O' / w
J 8'-0' 10'-O" 12'-0'
E #-- F G H X 35-9" 40'-3' 44' 9" BRACE DETAIL
NOTES:
DIAGONAL BRACE
1 THIS IS A TYPE 11 POOL IN ACCORDANCE 'RITII N.S.P.1 STANDARDS
JAN. 1909 AND BOCA CODE 1993 - SECTION 421 PANEL LENGTH NO.OF
t2 EACH BRACE WILL DE MOUNDED WITH A MINIMUM OF 1 FOOT OFCONCRET4'-0' e'-O' 9'-0' BRACE L
3 MAXIMUM 16 LENGTH - 4 - 3
9 MAXIMUM LENGTH OF DIVING BOARD - 8'; ]UMPSTAND - 8'.
4 'NO DIVING" LABELS MUST BE INSTALLED AROUND SHALLOW END WIDTH - 2 — 1 SEE NOTE 2
OF POOL IN ACCORDANCE WITH LINER MANUFACTURES 18 ENGTH - - 4 3
INSTRUCTIONS x WIDTH - - 2 I
ARNING x ENGTH — 5 = 4
/ / / / / / / / 40 WIDTH I 2 2
HORIZON T L.BR ACE
SWIMMING POOLS ARE DA.-4WOU S WHEN USED IMPROPERLY! CONSULT YOUI: 'STAKE
DEALER FOR SAFETY INFORVIATION ON IHE SAFE USE OF SWIMMING POOLS. T".__.,. .
If IS THE RESPONSIBILITY OF TOWN OFFICIALS.BOLDFRS AND HOME OWN=RSTU SPECIFIC :TIONS _ '
FOLLC?W ALL SAFETY RECCIMMEND OPONS OF N.S P.I..ALL LOCAL ORDANCE- 16 X 32 18 X 30 0 X 4�_; ALBERT
AND EQUIPMENT MANUFACTURERS. AREA-SO.f T. 512 64p gG0
S1-1:JNFD RECTANGLES
S 1
GALLON9 CC [4,600 30,500 !,1/4, WITH! 6' RLDIUS CORNERS
DATE TIME
CITY OF ORONO CALLED IN -
INSPECTION NOTICE SCHEDULED /i 12 7 Q=30
PERMIT NO. R&S" COMPLETED _ _
ADDRESS
OWNER CONTR.
TELEPHONE NO. �J 53
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= FINAL 14 SEWER HOOK-UP 06 PROGRESS
~ 0 EMO---SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
W
a
O
cc
O
4-
W
Cr
Q
2
W
W
cc
WORK SATISFACTORY:PROCEED OJECT COMPLETE
QC W ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. L PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Cont r o 'te:
Inspector.
White Copyllnspectoes File Canary Copy/Site Notice
IME
CITY OF ORONO CALLED IN [ -ash 47 AOT,6 C3
INSPECTION NQJJE SCHEDULED 9/—" A : Q
PERMIT NO. COMPLETED U— j
ADDRESS Gej,V
OWNER Wd_'g 4�AUE'S_3 CONTR. S7-40-Ac eeGS
TELEPHONE NO.
DESCRIPTION )nceD77.yc5 T�v2 �GeJ//1l/jf/,(�G DG L
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
F` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
cc
W
a
cc
O
CC
O
LL
W
cc
Q
Z
W
Z
W
rz
J
LaiORK SATISFACTORY:PROCEED PROJECT COMPLETE
ac evw
[ CORRECT WORK 8 PROCEED
W ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
00 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next'n ction 24 hours in advance.473-7357
OwnerlContr r n sit
Inspector.
White CopylInspector's File Canary Copy/Site Notice
MIA
CERTIFICATE OF SURVEY
Prepared for : ROBERT SUESS
LOCATION SURVEY OF: The West 1 /4 of the Southeast 1 /4 of
the Southeast 1 /4 of. Section 33 , �
Township 118 , Range 23 , Ilennepin County. 4,
0
3OD N
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30 9� o
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10,
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0
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N 2.9 19IyS�+
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1 I D. NO. 33-1 8-23
a 44— 0001
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Alor>tb ri9hf op way line off' INaterfvwn R04c
ORONO co
-- WATERTOWN ROAD __. - - _
SITE PLAN OROS® I
X APPROVED (, GRADING PLAN j
s ❑ APPROVED WITH REVISIO
GENERAL NOTES ❑ DISAPPROVED NS ?
1 BY 3.3i- 9l
o Denotes iron monument Proposed top of foundation DATE _
Denotes cross chiseled in concrete Proposed basement floor elev`df o_-�------ -
x 939.7 Denotes existing spot elevation Proposed garage floor elevation = J
939 Denotes proposed spot elevation
ez Denotes surface drainage BENCHMARK:
Dashed contour lines denotes proposed features
Solid contour lines denotes existing features
I hereby certify that this survey, plan or report SCALE
ALL -METRO LAND was prepared by me or under my direct supervision
— - ---- and that I am a duly Registered Land Surveyor
SURVEYORS under the laws of the State of Minnesota. g00K r'AGE
7 --
13 8
2340 Daniels Street
Q Long Lake, Minnesota 55356 I9 $p -� FILE No.
Ph: 475-1433 DATE —I__o REG. N0.
88048'x►