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Home My WebLink About2001-P03581 (demo) PERMIT CITY OF ORONO 2750 l�elley �arkway - PO Box 66 Permit Number: Po3ssi Crystal Bay, Minnesota 55323 Permit Type: Demot�c�on (952) 249-4600 Date Issued: 3i13�2o0� SITE ADDRESS: 4645 Bayside Rd MAPLE PLAIN,MN 55359 PID: 06-117-23-22-0009 DESCRIPTION: Proposed Use: Kesidentiai Census Code 645 Permit Class: Building Permit Type: Demolition Permit Sub-type(s): Demo-Principal Structure DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: F:;;:.^.'�;.�..:.^.,,�/µtl .7�.^.:.^,��`::�.�h�:......,:�.7 f�w. .-.,,..,.� A. .7��....�0.7 ..f�FF�:�� or Av A r .,l�r:..,,� \71/�1I� b, �..... t....,...... �... �b............,. m ast be abondoned. Inspection before backfilling. FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 50.50 APPLICANT: TERRANCE EID CONSTRUCTION,IN OWNER: Eric&Elizabeth Sims 19814 JOHNSON MEMORIAL DRIVE 4645 Bayside Rd JORDAN, MN 55352 Maple Plain,MN 55359 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 MI ESOTA BUILDING CODE REQUIREMENTS. , , f/ � k' (`�d?2 a-n, APPLI ANT PERMITEE SIGNATURE ISS BY SIGNATURE /�%.�� Copies: City,Applicant,Assessor,Finance Page 1 � . �o �d •` • ,.�/y.,w',r; ,r �' d:� , � � � .� S �l . 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: �=�$� �yS,o £ �"�::.�r� Occupancy Type: Residential Commercial OWNER'SNAME: �2K �o Lts.�t S�m:� Phone: MailingAddress: 46�'S 3.�ri+s,s�� 2 � City: nrzv,� �=� CONTRACTOR'S NAME: ��F'�+�£ E'�r� (�:��S7�c7�s,�Bus.No.: %5Z-�;2-277Z MailingAddress: (�1�14- ��n� MCma2r�rt �2, City: -Tc,��.:, m r.l Ss',�S 1_ Demolition if planned by means of: manual disassembly ✓ heavy equipment Permits Issued: # Well Abandonment In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as follows: l. The structure(s) shall be kept enclosed and/or secured until such time as demolition is complete. 2. Demolition debris will be kept off adjoining 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 w-hen all debris has been removed, before backfilling. 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 hannless 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 owner, 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 � $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) $ The undersigned hereby applies to the City of Orono for issuance of a Demolition Permit, agrees to do all wark in strict accordance with the ardinances of the City and the regulations of the State of Minnesota, and certifies that all stateme ade on this application are complete,true and conect. APPLICANT'S SIGNATURE: Date: .� � � OWNER'S SIGNATURE: '� ----�--= ��'� �^^ Date: � � � APPROVED BY: � Date: 3-$- O� / ) � M i n nesota Pol I ution Control A ency g �� October 4, 1996 Dear Sir/Madam: The Minnesota 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 Opportunity Employer•Printed on recycled paper containing at least 10%fibers from paper recycled by consumers. Guid�nce o� �n�iranmen�al �o�cerns A:�socia�e� ; �� ; : �% �v�iYh �uilc�in l�emc��ition � i�Ii�neso�a _ t' ' ' , �a�lufz�n e�nrzoz ' �ge� ` ` ; xtls;g� �: <. o ;: 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. ; , A�BES'I'��S Asbestos-Containing Nlaterial (AC1V� 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 AC1Vn ♦ ceiling tiles, textured spray, fireproofing, scratch coats or other treated areas ♦ cement asbestos board: also �:nown as Transite0, this material`vas 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 AC`S can be found almost any�vhere and a thorough inspection for ACI�I 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 MPCA Asbestos Team ten wor�:ing 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 AC�I 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 AC1�I that may be present. The recycling process could result in previously resilient ACI�I becoming crushed, crumbled, or reduced to a powder. If the ACI�I is not removed prior to demolition then the building materials containing, mL�ed in with, or coated with AC1�I may not be used for recycle. 1 ;:.::..:;>::::>:>;..::: ,: �,,,, _�,, ;.;� . , - „ ,... (�///��y��j,/^�( `�y�{(y `ry (�( ..'�.�'�'.:!��:::i.��.'.:.i"::;;....:.:�:�i::.�.:::::::.�:i.:::.:�:.::ji::::i:::i.�::r:��::ii:i:::::iii:i.liiiiii+i '::::i::i::::::..:i:ii:::� � �( .....: .' . �:i::::.::i::.i'.::i.'.:::ii:: �� . ..:�:� . . . .:: . :�.a<at�L1L�l,V,��...�,.F:.'�1J.� - �. ::::::i�,'.:::::':::.i.:: ... .......:...... .... \ .. .........:::.::'�ii�::.: :::::.i:::.::.�i:.i:.i:%.. . .:.' ..... .�.f. ...: ".:�.:�.;;.,.:.:' .i:i;� ...�:::i.?':�:':.":::::::.::::::.:...:...:'.:::'. ..................:........... ...............�:::::.�::.�::::.i:ii:v::::::::::::�ii::i::iii::::�::�:'iii�:::::::::.iii'riv.� ...................................................................... ....:. ................::.:........... ............ .......:.�:::::::::::.�iiiiij•ii: ..................::::.:::::...... ..............�..i::......... ......:::v::::.............. ............::v:::................::: .. .........:::.:::.:::.::.n..:J:�::::::::::::::::::::i ..................� 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 toxic 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. ;::.::.::: .;:. ;: , ;:: ::<:::::.::.,.:::::< .:: , ,,, < >:::>::>'::<::: ;::::::::>::.>.:::..::.:,.;.: : �P��IAL H��ARDO[�S V�AS�'E5: < Special Hazardous Wastes 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� wppliane�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 belo�v. < ; - ,< ��'I�ERGRQI1ti�D S�O�GE TAi�tKS; ; In a demolition any underground storage tank (IJST) must be identified and removed prior to demolition. In most facilities the presence oi USTs �vill be �:no��•n from the types of operations performed at the facility. The most common type of UST that you will be concerned tivith is old fuel oil tan{:s that have been abandoned. The following are some clues as to how to identify a potential UST. • 2 A site walkover may provide clues as to the presence of an abandoned UST. Heating oil tanks usually �xhibit 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 ground level and covered over. Fuel oil tan�:s 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 NIPCA. Contact the Tanks and Emergency Response 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. Metal 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 othernise 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. Escavation may also be an option, however, this is labor intensive, may be costly and will be disruptive of the integrity of the site. ' ; , _ �VFI�L�S . . — 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 well contractor needs to be contacted to properly seal the well(s). The following information includes some clues on how 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 `vhere records of old wells may be located: ♦ Minnesota Geological Survey (612) 627-478-1,��ater�vell records by section, township and range, and sometimes by address, ♦ Minnesota Department of Health `Vell Management Unit (612) 21�-OS11, Pre-1990 the wells are classified by year and the contractor that drilled the well, , � ♦ 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 ;::::::: :::>;:::::>::::::::::::''::.;. >::::::•:::::. �� `` ;.: ..::. , ;:: >:::`;;:::> �:':::::::::;::::>>:>:.; ; luG� _ : �A�t�'S.�C`�CsIHC�� :< •CFCs (chlorofluorocarbons) and HCFCs (hydrochlorofluorocarbons) are man-made refrigerants that destroy the ozone layer. �CFCs and HCFCs must not be released into the atmosphere. These refrigerants must be recovered by technicians certified by a U.S. EPA approved program using proper refrigerant recovery equipment. • Examples 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. _ _ ; FIRE EX�`II�T�II�S�ER� > ;;: •Some fire estinguishers contain halons which destroy the ozone layer. •Halons must be recaptured when recharging, servicing, or retirin�the unit. There are a number of companies in Minnesota that have the proper halon recovery equiprsPnt. � •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 removed from the facility prior to demolition. ; , > �a��v�a��o��.��v��r�r. ��c��r�B�� Aec�rT��`��s�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 have Industrial Solid Waste i�lanagement Plans (IS`V�IP) tbat allow them, under special provisions, to accept some of the following materials. 4 , � � Acceptable Materials: ♦ drywall (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 Unacceptable �Taterials: ♦ infectious `vaste (needles, body parts, dressings, etc. from hospitals, mortuaries, nursing homes) ♦ untreated sewage (sewage sludge, sludge compost, and septic tank pumpings) ♦ street sweepings (should be tested to determine if they are hazardous (TCLP)) ♦ tires (compaction difficulties, floating effect, and waste landfill space) ♦ major appliances (all hazardous materials must be removed including mercury, PCBs, and chlorofluorocarbon (CFC) refrigerant gas, commonly {:nown 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 wood or insulation If you have any questions about acceptance of any waste at a Demo LDF please contact your nearest MPCA Solid `Vaste Specialist. . , , , OTHER`TSSITES 5 , . � ! 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. >:.:::::::;:::> ::. ;: <: ....:: ...:::.::.: ..:.:::.::.:...::: ::..:::...:....:.:..:...:...:.:::�:.;.:;:�:.;�:::.::.::..:........ > , ' FOR 'v� _ >;:::;:>°°�<::<:s:::>:::::> ::::: ,;.:.::;::< ;;:;;::::.:<::.:<:;.>::;::::;;::.::<::::>::;:::>: ' <:; � 4RE��E3�t1VI�T�QN , .. :. .; ...;.;.::.::..;:>:;.:>:�>; :.: For more information about any of the above listed programs please feel free to contact the individual program or call the MPCA at 1-800-6�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 Well l�Ianagement Unit: (612) 21�-0813. This guidance document is not intended as a substitute for readinb 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 exhaustive listing of types of materials or projects to which the rules or regulations might apply. 6 , � ' Minnesota Pollution Control Agency Notification of Intent to Perform a Demolition �� Type of Notification [ J Original [ ] Amended ( ] Project Cancellation Demolition Contractor• Building Information• Name: 6t SOn� Cv�:%S'1,2�iC7r�:' C.1 /�UC: BuildingName: �Sfp£d7rr�, Address: ��?Q i��Aj'OC)!� �OR�> Address/Location: �45 �YSr t�� Z J City,State,Zip: 0%u�JC ; I��J City,State,Zip:�v�.00r'J� M� �'�'Z County: � Contact Penon: �f�+�+� 0 ZS'd� Phone Number(s): �S Z� ��1�- •?7 7� Phone Number(s): pi SZ-4�4�-�6 7� Age of Bldg.(years): a� Size of Bidg.(sq.ft.): =�5�� Number of Floors Including Basement Level(s): Z Building Owner: Present Use of Bldg.: �S��L^7✓�-� Name: ��i L .Slm� '��s��`�,� Prior Use of Bldg.: Address: 4lri`�S ��NS 10� 2 D Dates when demolition or intentional burning will Begin /�S-�P & End 3��+c�.��, :c`��S City,State,Zip: G2U�3 , �'1� �_ Notification must be postmarked or received ten(10)working days Contact person: 1 f2�y E iD before demolition begins. 'See item#5 for emergency demolitions. Phone Number(s): �SC- 4 '�!'Z'" Z 7'�L 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 (RACi1� in the building to be demolished,it must be removed by a licensed asbestos contractor prior to demolition. The State of NT�i 1- Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal. Is nonfriable ACM present iq the structure to be demolished ? [ ] YES [,i]'�10 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 AC�I left in place. Categ. I Linear Feet Categ. II Linear Feet Square Feet Square Feet Cubic Feet Cubic Feet CateE�I nonfriable A M means asbestos-containing packings, ateporY II nonfriable AGM means any material,ercluding g�skets,resilient floor covering,and asphalt roofing products Category I nonfriable ACh1,containing more than one percent containing more than one percent asbestos. asbestos that,when dry,cannot be crumbled,pu(verized,or `Category I nonfriable AC1I 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�1 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 & Location of ACM remaining in place (including floor# and room #): � '. , '� 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 all building�must be inspected by an EPA accredited inspector. - , , 4. Description of planned demolition and the specific method(s) that will be used: ��1J`! �l?t L(rPdl£:v�/ — 7,��C�LS '7�: f.�► 1L C�r �"i7L 5. If the demolition was ordered by a government agency, please identify the agency and attach a copy of the order: Name: Title: Authority: Date of Order(M/D/Y): Date Ordered to Begin(M/D/1�: * Notification for an emergency demolition must be submitted as early 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 AC11 or is suspected to contain any regulated AC�1,speciat procedures�fUST be followed. If you are unaware of the special procedures, instructions/regulations can be obtained by contacting the bIPCA 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 AC�I becomes crumbled, pulverized or reduced to powder: I�� la1�LL fU�7(r�7 �l�Gr''v2 %��KL?�i s" 7. Waste Transporter Information: 8. �Vaste Disposal Information: Transported Name: �Z� �o^�S�u�7t�1� Landfill Name: Transporter Contact ��'� ��-S a� Owner/Operator: Transporter Address:_ ��7� I��i%+� '2� Address/I.ocation: City, State,Zip: `b � d�^��, M'J City,State,Zip: Phone Number: ��"44c�— C��7� Phone Number: 9. I certify that the above information is correct and I am a bonafide representative of the demolition contractor or building owner and h authority to enter into agreements for my employer. Signature of Contractor/Owner G� .3 (� Q ' Date � Send or Fa�c to: For questions call: Asbestos Coordinator-Air Quality Division 612-296-7300 I�fi1 Pollution Control Agency 1-800-657-3864 520 Lafayette Road North Fax: 612-215-1593 St. Paul, l�f'�i 1 55155-4194 C�P� ENERGY CODE DESIGN BY ACCEPTABLE PRACTICE To Determine Compliance with the Minnesota Energy Code (Section 602 of the State Amended 1983 Model Energy Code) This form is only applicable to detached one-and two-family dwellings. The requirements herein are based on Table No. 6-11 in lieu of the criteria specified in Sections 602.2.1, .2 and .3. Building Address Q�4 S C�'`(_S�� Contractor or Owner L ��'Q,�C'� ��+� Co.11s�G'xC'1ro:�J, I��C• Building Element "R" Values Area (sc�ft� % of Ext. Walls Ceilings Design��Req'd 38 Walls (exterior) Design �CJ Req'd 20 � (w/o fdn) Floors (over unheated spaces) Design llJ Req'd 20 *Windows (in bldgs w/o �_ Design Req'd 12 sliding glass door) (glass) *Windows (in bldgs with a � Design Req'd 10 sliding glass door) (glass) Foundation Walls Design �� Req'd 5 (when insulating full depth of foundation wall) Design C/ Req'd 10 (when insulating only to frost depth and footings extend below) Slab-on-grade floors Design Req'd_(See Figure No. 3) **Doors (1-3/4" metal faced) Design �' Req'd 3 * All windows shall be double glazed or have storm windows ** Conventional doors other than metal require a storm door CERTIFICATION I hereby certify that I have completed the above information and that it complies with the Minnesota State Energy . Code. Signature Date � �,�J d� BCSD 3-89 CC/SM/6593 18 GUIDELINE TO (R) FACTORS FROM ASHRAE MANUAL OF TYPICALLY USED PRODUCTS AIR FILMS �R.� SHEATHING � Interior Air Film (Walls) 0.68 3/4" Wood Subfloor or Sheathing 0.94 Exterior Air Film (Walls 0.17 1/2" Plywood Sheathing 0.62 Interior Air Film (Vented Ceiling) 0.61 1/2" Particle Board 0.66 Exterior Air Film(Vented Ceiling) 0.61 Gypsum or Plaster Board 3/8" 0.32 Interior Air Film(Non Vented) 0.61 Gypsum or Plaster Board 1/2" 0.45 Exterior Air Film(Non Vented) 0.17 Gypsum or Plaster Board Si8" 0.56 Plywood 3/8" 0.47 BLOWING WOOLS Plywood 1/2" 0.62 Approx. 3" 9.00 Plywood 3/4" 0.93 Approx. 4 1/2" 13.00 Sheathing, Reg. Density 1/2" 1.32 Approx. 6 1/4" 19.00 Sheathing, Reg. Densiry 2�i'32" 2.06 Approx. 7 1/4" 24.00 Nail-Base Sheathing 1/2" 1.14 Approx. 14" 30.00 I Approx. 18" 40.00 ROOFS All other insulation materials Built-up Roofs 0.33 must be verified (R Factor) Asbestos-Cement Shingles 0.21 Asphalt Roll Roofmg 0.13 INSULATION Asphalt Shingles 0.44 Insulation: 2-2 3/4" Fiberglass 7.00 Insulation: 3 1/2" Fiberglass 11.00 SIDING Insulation" 6" Fiberglass 19.00 Aluminum Siding 0.61 Insulation: 3 5/8: Fiberglass 13.00 Aluminum with Backer 1.82 Insulation: 9" Fiberglass 30.00 Aluminum with Backer & Foiled 2.96 Insulation: 12" Fiberglass 38.00 1/2 x 8 Lap Siding (Wood) 0.81 Insulation: 8" Cellulose 29.00 7/16 x 12 Hardboard Siding 0.67 Insulation: 10" Cellulose 37.00 Asbestos Sidings 1/4 Lapped 0.21 Insulation: 12" Cellulose 44.00 Stucco (Brown and Finish Coat) ---- Insulation: 1 1/2" Thermax 12.00 Insulation: 2" Thermax 16.00 DOORS � 1 3/4" Solid Core Door .46 WOODS w/Storm, Wood .31 Fir, Pine & Similar Soft Woods w/Storm, Metal .26 1 1/2" 1.89 Pease Steel Door Insl/N/GL 7.45R .13 2 1/2" 3.12 Sliding Glass Door, Wood .65 3 1/2" 4.35 Metal .72 5 1/2" 6.87 WINDOWS CONCRETE BLOCK All Windows 8" Concrete Block (S & G Reg.) 1.11 (w/Storms 1" to 4" Space) .56 (Filled with Vermiculite) 1.93 Removal Double Glazing (RDG) .55 12" Concrete Block (S & G Reg.) 1.28 'Thermo or Welded 3/16" Air Space .69 (Filled with Vermiculite) 3.15 1/4" Air Space .65 8" Light Weight 2.18 1/2" Air Space .58 (Filled with Vermiculite) 5.03 (Other windows specifically tested 12" Light Weight 2.48 can use better ratings) (Filled with Vermiculite) 5.82 19 DATE TIME CITY OF ORONO CALLED IN INSPECTION PIQTICE / PERMIT NO. �� ' ' COMPLETED �� ( �• 30 ADDRESS %G�L�� //�t "��,L�� OWNER CONTR. TELEPHONE NO. � DESCRIPTION Ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 -SI 27 SEPTIC MAINT. 21 COMPLAINT J 07"T�EMO-FIN 15 SEPTIC INSTALL. 22 FOLLOW-UP 4Qi 09 ING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL = 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL J � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � � W � �� r- . � , ' -; " �� ' (j( � t� t'�;� � L t` �> � -, � ,l'" o [ C��lY�'{�+,� �1' �c�'JC7� ` a � 0 � W � Q � Z W � W � � d W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ��RRECT WORK&PROCEED ! ISSUE CERTIFICATE OF OCCUPANCY W ��5 CORRECT WORK,CALL FOR FIEINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContra tor on site: Inspector. r'�//t°c" G C? 2D� White Copyllnspector's File Canary CopylSite Notice