HomeMy WebLinkAbout2000-P02552 (Demo) PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: po2ss2
Crystal Bay, Minnesota 55323 Permit Type: Demoiition
(612) 249-4600 Date Issued: 6�i4i2oo
SITE ADDRESS: 1392 Baldur Park Rd
WAYZATA,MN 55391
P I D: 0 8-117-23-31-0003
DESCRIPTION:
Proposed Use:
Census Code 645
Permit Class: Building
Permit Sub-type(s): Demo- Principal Structure
Permit Type: Demolition Demo-Accessory Structure
DETAILS:
Approved per resolution#: ��� `� /
Separate permits required:
NOTICES/REMARKS:
T1F1��T(1 PRIT�If TPDI. AT�lll A(`('FCC(lRV CTRIT(`TTTRFC
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m zst be abondoned. Inspection before backfilling.
FEE SUIIIIMARY: Permit Fee: $ 80.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 80.50
APPLICANT: JOHN KRAEMER& SONS OWNER: GIL GEHLE
4906 LINCOLN DR 1392 BALDUR PARK RD
EDINA, MN 55436 WAYZATA,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOT BUII,DING CODE REQUIIZEMENTS.
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T PGRMITEE SIGNATURE � SUED BY SIGNATURE ��
Copies: City,Applicant,Assessor, Finance Page 2
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CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions
1. You may be required to obtain other permits, i.e. well abandonmment, etc.
2. Work must not begin unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call (612) 249-4600.
JOBSITEADDRESS: �3qZ QAIa`1'r ��'IG �0°��
Occupancy Type: ���Residential Commercial
OWNER'SNAME: ��� �' RO�A"""e �°�"1e Phone: atS2•a1�19• CLN6
Mailing Address:g$s� ��e�W 'E�. �"�.�1"� t + I'�N City:
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CONTRACTOR'S NAME: SO�r► �Cwew� �S°"`S Bus.No.: �►S t—�13 S-�1 t 00
Mailing Address: *�a►0� L�r►C0��r• �tti� City: C��;,�.0. . MF�
Demolition if planned by means of: manual disassembly
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�heavy equipment
Permits Issued:
# Well Abandonment
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows:
1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is
complete.
2. Demolition debris will be kept off adj oining property and/or the public rights-of-way unless
specific prior approval is obtained in writing for temporary use thereof.
3. Foundations shall be completely removed from the ground.
4. All demolition debris shall be completely disposed of off site in accordance with all
applicable PCA requirements.
5. Water wells must be abandoned in accordance with State Health Department regulations.
6. Inspection required when all debris has been removed, before backfilling.
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7. Within 5 working days of superstructure removal,a final inspection shall be requested. The
site shall be left clean and clear of all debris,with any excavation filled with earth level with
the adjacent ground elevation (except when such excavation is to be used as part of a new
building and such new building is actually under construction).
8. The undersigned owner shall and hereby does indemnify and hold harmless the City of
Orono, its agents, employees and assigns from and against all claims, damages, losses or
expenses,including attorney fees,against the City,its agents,employees and assigns arising
out of or resulting from the demolition described herein as performed by the property o��ner,
his employees, agents, subcontractors or assigns.
9. Septic systems must be abandoned per Minnesota Rules Chapter 7080. All septic tanks must
be pumped,crushed and filled with native soils. An inspection is required after the tanks are
pumped and before the tanks are crushed and filled.
PERMIT TYPE AND FEE CALCULATION
1� $50.00 - Principal Structure
✓ $30.00 - Accessory Structure
1. Subtotal of above permit requested $ $�•�
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ $O. SO
The undersigned hereby applies to the City of Orono for issuance of a Demolition Permit, agrees to
do all work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete,true and correct.
APPLICANT'S SIGNATURE: ate: 5 — 2�0- 00
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OWNER'S SIGNATURE: Date: .��� ���
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APPROVED BY: � Date: C� '(3 -C�(�
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/ " ��� Minnesota Pollution Control A enc
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October 4, 1996
Dear Sir/Madam:
The 1�linnesota Pollution Control Agency (MPCA) is writing to request assistance in informing
the general public of federal regulations and state rules regarding demolition projects. Recently
MPCA staff have encountered numerous instances in which a demolition contractor had obtained
a permit from a city or county office and commenced the demolition unaware of the state and
federal rules and regulations governing demolitions. Often contractors believe that by obtaining
a city or county demolition permit they have satisfied all requirements.
In an effort to address this problem, the MPCA would appreciate it if you could hand out the
enclosed documents along with your demolition permits. If the demolition permit applicants
have additional questions, please ask them to contact the MPCA Asbestos Team at the telephone �
numbers listed below. The MPCA is aware that many cities may already supply contractors with
this information and we appreciate your efforts.
Phone Numbers
(612)296-7300 or 1-(800)857-3864
Enclosures
520 Lafayette Rd. N.; St. Paul, MN 55155-4194; (612)296-6300 (voice); (612)282-5332 (TTY)
Regional Offices: Duluth•Brainerd•Detroit Lakes•Marshall•Rochester
Equal Opportuniry Employer•Printed on recycled paper containing at least 10%fibers from paper recycled by consumers.
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�`�' Guic�ance o� �nviranm�en�al C,�ncerns A�so�ia�ed,
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This document offers guidance on environmental concerns that need to be addressed prior to the
demolition of a building. The environmental concerns include: asbestos, hazardous wastes, special
hazardous wastes, underground storage tanks,wells, refrigerants/CFCs/HCFCs, fire extinguishers,
and other concerns. This document also includes guidance on what kinds of waste can and cannot
be accepted at a demolition landfill.
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>:.A�gES'��S '
Asbestos-Containing Material (AC1Vn is a special consideration in the demolition of old buildings.
Through the 1970s asbestos was used in over 3000 different building materials. Some of the more
common materials are:
♦ pipe, duct, and boiler insulation (includes many different types of ACI�
♦ ceiling tiles, testured spray, fireproofing, scratch coats or other treated areas
♦ cement asbestos board: also l:nown as Transite0, this material was used estensively as siding on
homes, ceilings and walls in commercial buildings, and any area where heat or moisture is
present.
♦ vinyl asbestos floor tile, old linoleum, and other resilient floor coverings
ACM can be found almost anywhere and a thorough inspection for ACNI must be performed prior
to any demolition. The NIPCA Air Quality Division Asbestos Team maintains a list of companies
that can perform this service for you. You can reach the Asbestos Team at the phone number
below. --
In a demolition a notification form must be filled out and sent to the 1�1PCA Asbestos Team ten
working days before any demolition is started whether the building contains ACM or not. If you
don't have this form, contact the Asbestos Team. The Notification form for a demolition contains
specific information on the dates of demolition and on the different types of ACVI and conditions
for how the ACM needs to be handled if ACM is present.
If any of the demolition materials are to be recycled it is necessary to remove any ACNI that may be
present. The recycling process could result in previously resilient ACI�I becoming crushed,
crumbled, or reduced to a po�vder. If the AC�I is not removed prior to demolition then the
building materials containing, miYed in with, or coated with ACM may not be used for recycle.
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Hazardous Waste is any waste that displays one or more of the following characteristics: '
• Ignitable (will ignite at less than 140° F�, solvents, petroleum products, thinners
• Corrosiv�(pH of 2 or less or 12.5 or more), concrete cleaner, paint stripper, bleach
• Toxic Characteristic Leaching Procedure (TCLP) a test to determine if a material will leak
heavy metals or other tosic materials
• Reactive, esamples include carbides, sodium hydrosulfide, magnesium, potassium
Hazardous Wastes must be removed prior to demolition and can not be disposed of at a demolition
or sanitary landfill. If you identify any containers or materials that you believe may be hazardous
you must have them tested before proceeding. If you have any question please contact the MpCA
Hazardous Waste Division at the number below.
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Special Hazardous `Vastes are materials that may not meet the above requirements but have been
given special consideration because of their specific properties. The following is a list of special
waste types and the materials in which you might find them. Special Hazardous `Vastes must be
identified and removed prior to demolition.
♦ Dry Cell Batteries (button, nickel cadmium, small lead acid rechargeable and other dry cells
♦ Antifreeze
♦ Circuit Boards (old electrical equipment)
♦ Polyclorinated Biphenyls (PCB) found in light ballasts, small capacitors in old appliances, and
transformer oils
♦ Mercury (fluorescent lamps, mercury switches, mercury vapor lamps, thermostat probes, metal
halide lamps, relays, high pressure sodium lamps, thermometers, neon lamps, thermostats,
manometers, and gauges). Many mercury containing materials were used i� wpplian��s, or
industrial switches or controls.
If you have any questions regarding the identification, transport, or disposal of special hazardous
waste contact the Hazardous Waste Division at the phone number below.
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; T��tI1ERGRQU�tI3 S`TO�.GE T�1;NKS
In a demolition any underground storage tank (UST) must be identified and removed prior to
demolition. In most facilities the presence oi USTs tivill be I:nown from the types of operations
performed at the facility. The most common type of UST that you will be concerned with is old fuel
oil tanl�s that have been abandoned. The follo���ing are some clues as to ho�v to identify a potential
UST. ,
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A site walkover may provide clues as to the presence of an abandoned UST. Heating oil tanks
usually exhibit spillage during filling, especially if the tank is old and has been filled repeatedly over
a number of years. Staining of the soil with or without the characteristic odor of fuel oil may be an
indicator of the presence of an abandoned fuel oil tank. If the soil appears to be undisturbed, check
for the presence of a fill pipe or a fill pipe that may have been cut off below ;round level and
covered over.
Fuel oil tanks are generally buried near the foundation of the building. Check the basement of the
structure for the placement of the furnace and any piping to an outside wall that may remain. If
the piping has been removed, look for a hole or patched hole in the wall in the general vicinity of the
furnace or the area where the furnace once resided. The fuel oil tank, if present, should be on the
other side of the wall, near the foundation. Fuel oil tanl:s of greater than 1,100 gallons capacity
should be registered by the tank owner with the I�IPCA. Contact the Tan�:s and Emergency
Respon:e Section at (612) 297-8679 to see if there is any information that indicates the presence or
former presence of a tank at this site.
USTs are generally buried 36"-42" below ground. Nletal detection devices such as those used by
NSP to locate metal gas lines and electrical wires may be capable of detecting the presence of an
UST if it isn't buried too deep.
Soil borings in an area of the site suspected to contain an UST can be conducted, but this can be a
costly option. If the soil is sandy or otherwise relatively porous, a metal rod may be driven into the
ground to a depth of 48" or so in areas suspected to contain a buried UST. E�cavation may also be
an option, however, this is labor intensive, may be costly and will be disruptive of the integrity of
the site.
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The presence of unsealed wells is a concern in many older buildings. Any unsealed or improperly
sealed wells need to be identified and a licensed w•ell contractor needs to be contacted to properly
seal the well(s). The following information includes some clues on ho�v you might locate an
unsealed well and who to contact to learn more about them.
Locating unsealed wells is a combination of research and educated guesses. There are three areas
where records of old wells may be located:
♦ Minnesota Geological Survey (612) 627-478-�, �vater well records by section, township and
range, and sometimes by address,
♦ Minnesota Department of Health Well �Ianagement Unit (612) 21�-0811, Pre-1990 the wells are
classified by year and the contractor that drilled the well,
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♦ City Inspections Department and local well contractors. ,
Another way in which to identify unsealed wells is to look for clues: some clues are:
♦ windmills, usually would use wind power to draw water out of a well
♦ unaccounted for pipes or areas in the foundation where pipes used to run
♦ the building was constructed and occupied prior to municipal water being available to that area
♦ well pits or shacks
a magnetometer may be used to identify metallic objects within 3-4 feet underground
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•CFCs (chlorofluorocarbons) and HCFCs (hydrochlorofluorocarbons) are man-made refrigerants
that destroy the ozone layer.
•CFCs and HCFCs must not be released into the atmosphe:e. These refrigerants must be
recovered by technicians certified by a U.S. EPA approved program using proper refrigerant
recovery equipment.
• Esamples of appliances that contain CFCs and HCFCs include:
♦ refrigerators ♦ dehumidifiers ♦ central air conditioners
♦ room air conditioners ♦ vending machines ♦ heat pumps
♦ freezers ♦ chillers ♦ ice machines
♦ food display cases ♦ water coolers
•Refrigerant substitutes (including HFC-134a) must also be recovered and not vented to the
atmosphere.
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•Some fire estinguishers contain halons which destroy the ozone layer.
•Halons must be recaptured `vhen recharging, servicing, or retirin�the unit. There are a number
of companies in Minnesota that have the proper halon recovery equipr�Qnt. �
•Halons can be used as total flooding agents in areas such as computer rooms, libraries, spaces
floors, and near electronic and medical equipment.
•Halons are also found in some portable fire estinguishers.
Halon fire extinguishers must be remo��ed from the facility prior to demolition.
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: DEMOL�'I'ION LA�'II��L ACC�PTABLE A�I3 �A�C�'T`ABI��t'trAS'I'�S
In the disposal of demolition debris, certain materials may or may not be acceptable at the
Demolition Land Disposal Facility (Demo LDF). Certain Demo LDFs ha��e Industrial Solid `Vaste
�Ianagement Plans (IS�VI�IP) that allow them, under special provisions, to accept some of the
follosving materials.
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� � •Acceptable Materials:
� ♦ dt-ywall (demolition only) ♦ untreated wood ♦ ceramic fixtures
♦ plastic ♦ conduit ♦ glass
♦ insulation (fiberglass/cellulose) ♦ wiring ♦ roofing, shingles
♦ tile (ceramic, floor,vinyl) ♦ metal ♦ built-in cabinetry
♦ asphalt ♦ butiminous concrete ♦ masonry
♦ concrete (including rebar) ♦ masonry/bricks ♦ tree stumps
Burned out buildings: must be sure that no hazardous materials or asbestos-containing materials
remain and that the threat of smoldering or reigniting is controlled. Some Demo LDFs may not be
able to accept burnouts because of the potential for hazardous materials to be present. In addition
burnouts pose a serious threat of smoldering or reigniting at the landfill. Check with the Demo
LDF before brin�ing the material to the landfill
tinacceptable Materials:
♦ infectious waste (needles, body parts, dressings, etc. from hospitals, mortuaries, nursing homes)
♦ untreated se�vage (sewage sludge, sludge compost, and septic tank pumpings)
♦ street sweepin�s (should be tested to determine if they are hazardous (TCLP))
♦ tires (compaction difficulties, floatina effect, and waste landfill space)
♦ major appliances (all hazardous materials must be removed including mercury, PCBs, and
chlorofluorocarbon (CFC) refrigerant gas, commonly l:nosvn by the trade name FreonO
♦ yard waste (creates leechate, gas, settlement problems, and wastes landfill space)
♦ household waste ♦ paint cans ♦ construction waste
♦ cardboard ♦ caulk tubes ♦ agricultural chemicals
♦ machinery or engine ♦ mattresses or ♦ treated lumber
parts furniture
♦ railroad ties
Some types of Industrial Waste may be accepted at a demo LDF depending on the individual
landfill's permit. Industrial `Vaste typically accepted at Demo LDFs includes,
♦ asbestos-containing materials
♦ construction waste that is the same as demolition waste, such as �vood or insulation
If you have any questions about acceptance of any waste at a Demo LDF please contact your nearest
MPCA Solid `Vaste Specialist.
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< > ` _OTHER ISS�,T,ES >
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Other issues that may arise include local demolition permits, gas lines, and electrical connections.
The Gopher one-call can be used to identify gas lines. Also,you are reminded that for all �
demolitions,whether asbestos is present or not, the notification form must be sent to the MpCA
asbestos team.
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For more information about any of the above listed programs please feel free to contact the
individual program or call the MPCA at 1-800-b�7-3864.
Asbestos Team: (612) 297-86$�
Underground Storage Tanks: (612) 297-8679
Hazardous Waste: (612) 297-8�11
Refrigerants/CFCs/HCFCs: (612) 297-7153
Demolition Debris Disposal: 1-800-6�7-3864 (identify the location in question for the�proper region)
Minnesota Department of Health `Vell Nlanagement Unit: (612) 21�-0813.
This guidance document is not intended as a substitute for reading the rules or regulations and
mal�ing your own independent determination of its applicability to your demolition. Examples in
the guidance document do not represent an eshaustive listing of types of materials or projects to
which the rules or regulations might apply.
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, Minnesota Pollution Control Agency
Notification of Intent to Perform a Demolition
'�� Type of NotiFcation [ ] Original [ J Amended [ ] Project Cancellation
Demolition Contractor• Building Information•
Name: � QA���+a1 �' S�`^S
Building Name:
Address: ���d� C.O • �� �'3 Address/Location:__�3�Z QAVN! �►�'� Q�
� City,State,Zip: ���s . M N
City,State,Zip:�AP���g _ M N S S3�13 county: �L���Q ��`^
Contact Person: h � Phone Number(s): N.�.
Phone Number(s): 36q� SOZ t 'C�'�� Age of Bldg.(years): '? Size of Bldg.(sq. ft.): ��
q'3$- �13�. �f�.
Number of Floors Including B�sement Leve((s): �.
Building Owner•
Name: ��� � .�O�tA�w.� Present Use of B(dg.: C�"'��
c 6e�.�Q ,p��
Prior Use of Bldg.: �3���v�e�
Add:ess: �$SZ ��es�^� C.: R�e.
Dates when demolition or intentional burning
will Begin �•10• a0 & End �0•10-00
City,State,Zip: Ee�Qv► �"i�►�i'�Q , MN SS3�'1�1
Notification must be postmarked or received ten(10)working days
Contact person: �e�� Or ��7��►r►�C, before demolition begins. 'See item#5 for emergency demolitions.
Phone I�'umber(s): �S Z— �y-`" �Z•�"�� Boch Beginning and Ending dates should be amended in writing as
necessary to reflect current project dates.
If there is>260 linear feet or>160 square feet of Regulated Asbestos-Containing Material (RAC1Vn in the buildine
to be demolishe:;, it must be removed by a licensed asbestos contractor prior to demolition. The State of N�i 1-
Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal.
Is nonfriable ACM present in the structure to be demolished ? [ ] YES �O
If YES complete items 1-9. If NO complete items 3-9.
1. If ACM will be left in place for the demolition indicate the amount of Category I and/or Category II
nonfriable ACM left in place.
Categ.I Linear Feet Categ. II Linear Feet
Square Feet Square Feet
Cubic Feet Cubic Feet
CateQ�I nonfriable A M means asbestos-containing packings, �tgQo�-v II nonfriable A .1��means any material,excluding
gaskets,resilient floor covering,and asphalt roofing products Category I nonfriable ACM,containing more than one percent
containing more than one percent asbestos. asbestos that,when dry,cannot be crumb(ed,pulverized,or
"Category I nonfriable AC�I is not allowed to remain in place reduced to a powder by hand pressure.
for demolition if it is in poor condition. 'Category II nonfriable AC�I is not allowed to remain in place
for demolition if it has a high probability of becoming crumbled,
pulverized,or reduced to a powder during demolition,transport,
or disposal. (ez transite,cement,slate roofing)
2. Description & Locatio❑ of ACM remaining in place (including floor# and room #):
1 . .
3. Company and/or individual that conducted the building inspection and the procedure used to determine the
presence or absence of ACM(including analytic method): `Prior to demolition ail buildings must be inspected by an EPA
accredited inspector. �
__ Av+�rO� �v�Aly'1�CA1 ��a.0
ee O.ct�ed
4. Description of planned demolition and the specific method(s) that will be used: �rOG� ��_
� ,00►�� ��'�0 avw.ls "�f v�S �.1y il b4C� �►O�,
5. If the demolition was ordered by a government agency, please identify the agency and attach a copy of the
order: .
Name: N./4. Title:
Authority:
Date of Order(M/D/Y): Date Ordered to Begin (M/D/I�:
* Notification for an emergency demolition must be submitted as eariy as possible before demolition begins,but not later than the
following working day. A demolition is considered an emergency ONLY when the facility has been deemed structurally unsound and
in danger of imminent collapse. If the structurally unsound building is known to contain any regulated ACbf or is suspected to
contain any regulated ACb1,special procedures 1IUST be followed. If you are unaware of the special procedures,
instructions/regulations can be obtained by contacting the bfPCA at the address or phone number listed below.
6. Description of procedure to be followed in the event that unexpected RACNI is found or Cat. II nonfriable
ACM becomes crumbled, pulverized or reduced to powder:
C°'`�� {�`^!1.S'��v�^ 1'�hA�`/T�CA� ��� a J�S t° .
7. Waste Transporter Information: 8. `Vaste Disposal Information:
Transported Name: O����a �' SOr►T Landfill Name:
Transporter Contact: Owner/Operator:
Transporter Address Address/Location:
City,State,Zip: Ciry,State,Zip:
Phone Number: Phone Number:
9. I certify that the above information is correct and I am a bonafide representative of the demolition
contractor or building owne d ha author'ty to enter into agreements for my employer.
Signature of Contractor/Owner Date 5-Z 6-00
Send or Fax to: For questions call:
Asbestos Coordinator-Air Quality Division 612-296-7300
I�IN Pollution Control Agency 1-800-657-3864
520 Lafayette Road North FaY: 612-215-1593
St. Paul, i�1 55155-4194
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� �r-���,�, �:";�;�� otnce: (952) 541-4805
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John Kramer and Sons
A,tm:N�ich�ae
49(�Linco2n Drive �
Edi„na
MN SS436
June 5`", 20Q0
Re:- Property Ivcated at 1392 Baldur Fark Road. Orono. MN.
Dear MicheIle:
Further to ou�visit co the above referenced property on 5/31//d0 for the�ur�pose o�
coz�ductang a deza�oaxaon asbestos xnspection, we aze pzepared to state rhat no asbescos
containing building materials were found to be contained in or on the fabzxc o�txte structuxe.
Iv�o samples other than from the fabzic o�the building that is planned for demolition wexe
taken oz anatyzed and this report relates only to the residence located at 1392 Baldur Park
Road in O�co�a,MN, 45 sa�nnples of suspect building materials were callected and analyzed
in our laboratory by Polarized Light Microscopy. Please see attached aotes,
Duri�g the cou�rse of the survey ten gallons of paint in thc basennent were z�oted.
If you kaave any questions,please call me at tbe number above. �
Thank you.
Sincerely, �
Tom ey
Angs�om Analytica�,Zr�c.
Fu1!Service Laboratory and on-site lndustrial HygJene Senrices for the Nazerdous Maferls!Abatement lnduscry
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Prega�by: Angstrom Analyttca],Ina �� `�'. -� � c
Q�'°�'�`�` ` ngstrom Anafytics�i� _
t220�Prinoeton Avenue•�den Pral�fe,MN 5534T .. . : ••�,
Ofttce: 6�2 941-48�5�FAX: 612 8,29-7273 :��==�0 Er�vironrnontal 5ervtca9 m
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PSD � pooaKial fa ai�ufica*t damage EA � fminR ND = no aabestoe xaa deteard in�hc amplt
8uikling iYarne: 1392 Baldur Park Roa�d,Qrono,Mn ��a�a r�=n.�r� E
Survey Date� SJ31I� � _ ���r«am,s� 'ra� q T�oyu Ns Q ����S°�e�a m
' [@ : litac oc nu a muge cHR Qu�.oula iYAc mr[mal aa.00esdLila d
D . owdaau damege AM � Amaiat < � ]ca�thtn value�ecn�xd @
p[OJ€Ct�(1. jOhll KI'81i1P1 dII�$ORS sD _ e CROC � (�ocsdo�tt • � TJwse aam Lea we�e oai eeo[ysed_T6�se N
Aun:Michelle °` "
��n� tew3h ae�nr�sd.camsiMrn,wich cbe
onalyr�ed sm�•1u ip�hs hanogenews aa. ii
4906 Loncoln Ikive � ' �f°°` '�' - ^�`�'�°' N
Edina,Minnesota 55436 sf - '�""`tDOC � - �10�'7�"° 3
Sample Types of Damage Respon.�e ,D
I,o�tion Materi�lIdentification Namber Asbcstcs % Quantity Units Cund. Potential Rating z
c�
ii_�c +��.Ss;:„� ,:,xs'zx ;� ey Rer x . .,. a ;:> >� ,�c;z2 .�t: g.c k�� '>'$ ,., ': �. r R�� >";'a�x �< : : �[ � i�.�. U}
� �S3'�� t'il7 .E-�� 3� S PS'74�9JAk . . ..' S , e{q 6 �.�� 4 '� St� fi��i � - i L�.. Srb 4��2 �.?,Yt2�'.
�_'c -o� yy x>�^ x f;. ..,..,.>..�tea.2b2�9�:�F.F:,i��.��Z'S�-3 �Ssr ��?t n$Z�'•�i'�,3 arx,i,a> w'i nMo? � �' � �=Sk RD?�+�i,^� ..dX:..<s ..F� n ,P.� ^-�' "I
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. ., s-,. . . :. . . _-,:. >,...,. , _ « ...,.',. .x,_>_� • .... ._,>.
Kiichcn white linoleucn w/squazes l [0 3 �1D - 70-RO SF D PD � o
" iinolearn adhe�ive 4 ro 6 ND - 70-80 SF N PD U 3
D
" white floor filIu 7 to 9 ND - 70-80 SF D PD � z
n
Main Floor white ceiling texture 10 io 72 ND - 350-4tH1 SF D PD 0 �
'Thmu o�[ sheetrock 13 to]5 ND - 3500-4500 SF i� PD d �
M
Bathc�oorn white and gold Iinoleum 16 to 1$ ND - 30-40 S F D PD 0 �
�
" brwon linoleum adhesive 19 to 21 ND - 30-40 SF D PD 4 �
Li ' Room fireplace martac 22 to 24 �1D - 100-12(} LF D PD 0 �
Basement laster 25 co 2'7 ND - 100-F25 SF D PD 0 �
Wutdows white and y ca¢lk 28 to 30 ND - 5�-7Q LF D PD 0 �n
N
Fmnt Entry Stairs black mastic-I�e�atexial 31 to 33 ND - 15-18 SF D PD (� N
.�c�ior �r�aper 34 to 36 rm - 35oa�000 s� b PD a �
Roof underlayment 37 to 39 C�IR cl 700-1000 SF D PD 0 `D
" silver stiingles 4fl to 42 G'HR <1 700-1000 SF D PD � n�i
" brown shingles 431045 QiR <I 700-14i)0 SF D PD � w
Garage silver shiagles Ref 40 to 42 � <I 350�400 SF D PD 0
��'��S�d � i xRA ��'.Y. 11 Y.- �.R -.:--4'r.:�,�t4 n # ' _��vti i..'�-.�f� - _ d� Z -:.>r"¢�:.,ti•- � _fc L^' �,_r_�.>4�,k +<K9' ��
. :�r s x a.r.,a�-... - o.z�.� y k^' 't`i�x K �_ �o '~��F�,.tr.�?k?
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.. . , , _x-_ ..:.., „_, � .,.� . _ u. han �. ... �' � - ,�,� ,. .`.
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FuH Sarvi�Laboratory arld On-Srte lndustrial Nyglane Services for the Hazardous Mat�ri�Abaternent lndusJry @
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CITY OF ORONO CALLED W �I D��Z�X) �� E��'l^-
INSPECTION NOTICE SCHEDULED �- � -cx� �'u�'�,�,-.
PERMIT NO. ���'Z�J�jZ COMPLETED ��'! Z2-�r �
ADDRESS I�`'1'L I?�c_�.� lciG� p��-i ,
OWNER Gj�l��l��:i CONTR. Jc;Ylirt k-f'Cz��� si�s
TELEPHONE NO. �l,� '_� 13`��
� DESCRIPTION ��I'Y1C I ��� 9�
ty� 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 5 F 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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d�WORK SATISFACTORY:PROCEED �PROJECT COMPLETE
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
Inspector.���.2���
White Copyllnspector's File Canary CopylSite Notice
DATE TIME ,/
CITY OF ORONO CALLED IN -� -��' �' ��
INSPECTION TICE SCHEDULED �—� �
PERMIT NO. d I �� COMPLETED
ADDRESS
OWNER � CONTR.
TELEPHONE N0. I 3�— qI ��
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FI�LING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FIN 14 SEWER HOOK-UP O6 PROGRESS
7 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
-FINA� 15 SEPTIC iNSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��1NORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W [7 CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O C� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
[1 CORRECT UNSAFECONDITION WITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
C]STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C] INSPECTIONREQl11RED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContract on site:
�
inspector. Gr-irC. G�-�7�
White Copyllnspector's File Canary CopylSite Notice