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Home My WebLink About2016-00242 - antenna replacement � � CITY OF ORONO * Z 0 1 6 - 0 0 2 4 2 * 2750 KELLEY PARKWAY DATE ISSUED: 03/15/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2345 BLAINE AVE PIN : 17-117-23-34-0011 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 005 BLOCK 009 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL- BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 15,000.00 NOTE: ANTENNA REPLACEMENT APPLICANT PERMIT FEE SCHEDULE 278.7'7 PLAN REVIEW 181.27 BLACK&VEATCH CORPORATION STATE SURCHARGE(VALUATION) 7.50 7600 S COUNTY LINE RD SUITE 1 TOTAL 467.54 BURR RIDGE, IL 60527- Payment(s) (913)458-1200 CHECK 42412661 467.54 OWNER (WELL NO. 3 PUMPHOUSE), CITY OF ORONO 2345 BLAINE AVE PO BOX 66 CRYSTAL BAY,MN 55323- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to 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 time for due cause. � �� /5 , /� Applicant Permitee Signature Date Issued By Signature Date . � CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS ,--. /�O�O Mailing Address: Permit number: l�o-� �/ PO Box 66 / Crystal Bay, MN 55323-0066 Date received: � �, , � Street Address:' Received by: . ��l fiVl.(,� �` tiF � 2750 Kelley Parkway Plan review fee: �,ykF�ii�� Orono, MN 55356 __ Main: 952-249-4600 Total Fee: Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 2�j�s j�L,r�.�,v,C /�v� Dr�v..Jc� � i��n/ 55.3�J / Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 6c_,�,-G-c � ✓�.a.+�H av Bc.�.�-F o.� �i%C�� State License# ,�,,� Expiration Date: — Phone: (cell) �j �3 45�S /C�2 S (office) Mailing Address: Cit : ZIP: Contact Person: 5a � �/ � � �,p Applicant is: ntractor I (Circle One) Email and/or Fax: ve� ��r�s� b�J �I�n� PROPERTY OWNER INFORMATION: Name: r�T1 oi� �2vn/O -' �vK�, � �.,1v2�.� Phone (day): Address: City: ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Descri tion of ro�ect: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply ❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Offce/Commercial ❑ Relocation detached garage ❑ Residence ❑ Private Sewer '�Other: (specify) �F Nr/A ❑ Multiple Family/Condo ❑ Retaining Wall(s) �Eoc,��E n,�`.�i ❑ Public 4-feet or greater ❑ Public Water "*Any earth movement may also require �Commercial ❑ Storage MCWD review 8�permits. Industrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (speCify) ❑ Othef(speCify) 15320 Minnetonka Blvd Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 wwvd.minnehahacreek.or Estimated Construction Valuation (excluding land) $ /S ,��r� Last Updated: January 2016 , , STRUCTURE INFORMATION: SE� �4,VT'�iYN�- SL�� /-}-l�pL.�Cf}-i^ic�^J 1.Structure Dimensions .Structure Dimensions(continued) � � a. Length(ft.)= Number of bedrooms= 2. Occupancy: b.Width(ft.)= Number of garage stalls: 3. Occupant Load: Areas in square feet Attached= c. Basement= Detached = 4. Type of Constructi d. 15'Story = e. 2"d Story 5. Code E on: f. '/2 S ry = g. otal Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ Buildin Permit Escrow A reement and Fees ❑ Plan Review Fee ❑ ❑ Com leted A lication Form ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/�x 11 set ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements ❑ Surve —2 full size, to scale meetin ALL surve requirements ❑ Hardcover Calculations ❑ � Se tic S stem Certification ❑ Minnehaha Creek Watershed District(MCWD) Permit or Documentation from MCWD statin no ermit is re uired ❑ Landsca e Walls and/or Retainin Wall Plans ❑ � Stormwater Pollution Prevention Plan SWPPP ❑ Access Permit ❑ Data Privacy Advisory Form APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; . Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • Certifies that the information supplied is true and correct to the best of his/her 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 alternative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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 information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information,the application may not be issued. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. ApplicanYs Signature: S� l�,�v�t..�.�lry s,T� >9,0��,c�9-��n/ Date: Owner's Signature: Date: Last Updated: January 2016 } a O U � W � City of Orono � � 2750 Kelley Parkway � � W� Orono MN 55356 952-249-4600 J � � Q� Receipt No: 3.015197 Mar 15, 2016 N ~_ .� �} �� Black & Veatch � W� Previous Balance: .00 ?W Permits �Q 2016-00242 2345 Rlaine 278.77 Z� Ave 101-32520 Zoning Permit Permits 2016-00242 �g�,27 101-34410 Plan CheckiSite Exam Fees Permits 2016-00262 7.50 101-20802 Due to govts-State --------------- Total: 467.54 --------------- --------------- Check � Check No: 424126618 467.54 � Black�& Veatch � � Total Applied: 467_54 �" Chan e Tendered: .00 x " 9 � a M 03/15/2U16 09:33AM J Z '_ c`r '�` o ... �n O o � � � U' Z � � n Z � m � � � H � � U -a Q c - �� E Z p � � m� O � � � �n � � � � d Z � � � " ¢ N � > o � L � o O � u, � � W , �" �+ U o � � N � X �[ „' � O V (n A o � m � � O � V � '� y Y C � V W � � � ui E � �_� W W = <j a ��`I W Q Q O � J !��l � o a � �° _ QBLACK & VEATCH Building a WOfld of difference` March 2, 2016 VIA FEDEX DELIVERY City of Orono Attn: Director of Public Work/City Engineer 2750 Kelley Parkway Orono, MN 55356 RE: New Cingular Wireless(AT&T)Antenna Site Application Site Name: MRUMW012864/HWY 51 AND 15 Water Tank MNP 2016 Carrier Add/CASPR 3511796590/FA 10104030 Site Address: 2345 Blaine Ave.,Orono, MN 55391 Director of Public Works/City Engineer: Enclosed in this package please find AT&T's completed Antenna Site Application; two(2)sets of 11"x 17"construction drawings dated OU22/16, structural analysis,two(2)partially executed escrow agreements, letter of authorization from AT&T, equipment spec sheets, cashier's checks in the amounts of: $10,000 for escrow account and $467.54 for building permit. AT&T is proposing to upgrade its existing wireless telecommunications facility by adding three (3)antennas,three(3)remote radio heads,two(2)surge suppressors and one(1) DC power trunk as well as other tower related equipment to the existing water tower as part of AT&T's MN 2016 Carrier Add project Once your review is complete, please let me know so that I may coordinate pickup of permit. Please feel free to contact me at 913-458-1025 or email verduzcos@bv.com if you have any questions, concerns, or require any additional information. Thank yo�i very much for your attention to this matter. Sincerely, Black& Veatch Corporation � � Sal Verduzco Site Acquisition Specialist Enclosures Black&Veatch Corporation�7600 South County Line Rd,Suite 1 Burr Ridge,IL 60527 USA�Telephone:913.458.1200 ANTENNA SITE APPLICATION CITY OF ORONO I �i<Iin_ I clr��m I�.qui�nn�nt ,Alu�lilir�iii��n� �\�I�Iiii��n, ('I Il' ��'A"II�:R l�O\��I�:IZ SI I I�.S Name of Water Tower/Antenna Site: Navarre (Kelley Parkway or Navarre) Wireless Carrier: New Cin�ular Wireless d/b/a AT&T (Complete corporate name of Lessee) Wireless Carrier Corporate Designation: LLC 1. Name of Applicant: Sal Verduzco for Black& Veatch on behalf of AT&T (Applicant is the existing tenant, if representing the Applicant; attach a letter that designates such) 2. Address of Applicant: 7600 South County Line Road, Suite 1, Burr Rid�e, IL 60527 3. Contact Person for Applicant: Sal Verduzco Telephone; (913� 458-]025 Cell: e-mail verduzcos(a�bv.com 4. Technical Advisor(A&E Finn): Ulteig/ Isaac Odlan Telephone: (612) 710045-44 Cell: e-mail [saac.odlan(r,�,ulteig.com 5. Proposed Radio Band: No chan�es to existin� 6. Proposed Radio Frequency(s): TX: 2350Mhz—2360Mhz and Rx 2305Mhz-2315Mhz Will the Applicant be utilizing a radio spectrum that does not require an FCC license? Yes No (Circle One) 7. Type of Service (SMR, ESMR, PCS, Cellular, Two-Way Paging, Microwave, Wi-Fi, WiMAX, etc.) Cellular 8. Unlicensed spectrum? Y N Circle One) If yes, identify in detail the portions of the project to use an unlicensed spectrum. Designate this as an Attachment. If utilizing a Distributed Antenna System (DAS), provide Radio Frequency Coverage Maps prepared by the FCC Licensee(s). Initial here to indicate Attachment has been included. 9. Will this site be interconnected via radio frequency transmissions to any other site or sites now constructed, proposed or anticipated (Interconnection includes one or more radio frequency links for the purpose provide for"back-haul"from this site to a switching center or centralized node location) ? Y /N Circle One) 172909v1 1 Of 5 If yes, what will the method of interconnection be? If yes, attach details and specifications. Initial here to indicate Attached Specifications. 10. Antenna equipment—Attach applicable specifications. A.Number of antennas 12 B. Number of zones 3 C. Antenna dimensions& Weight of Existing& Proposed See Table Below D. Antenna type, manufacture & model no. See Table Below Existing Antenna Manufacture Model# Dimensions Weight Type (inches) (lbs.) (4) Panel Kathrein 80010766 96x 11.8x 6 58.4 (2) Panel CCI HPA-65R-BUU-H8 82.8x 14.4x 7.3 53 (1) Panel CCI HPA-65R-BUU-H4 48X 14.8x 9 34 (2) Panel Kathrein 80010764 55.2x 11.8x 6 40.8 Finai/Proposed Antenna Type Manufacture Model # Dimensions Weight (inches) (Ibs.) (4) Panel Kathrein 80010766 96x 11.8x 6 58.4 (4) Panel CCI HPA-65R-BUU-H8 82.8x 14.4x 73 53 (2) Panel CCI HPA-65R-BUU-H4 48x 14.8x 9 34 (2) Panel Kathrein 80010764 55.2x 11.8x 6 40.8 E. Number of Remote Radio Units (RRU)_See Table below F. RRU dimensions See Table below G. RRU type, manufacture & model no. See Table below Existing/Proposed RRU Manufacture Model # Dimensions Weight type (inches) (lbs.) (3) Existing RRH Alcatel-Lucent RRH2x40-AWS 24.4x 10.63x 44 6.7 (3) Proposed RRH Alcatel-Lucent RRH4x25-WCS 3l.Sx 12x 8.7 70 172909v1 Z Of$ H. Transmission line or cable manufacture & model no. _No changes to existing coax I. Size of cables Number of cables J. Antenna location on the tower: 90 /230 /340 (N, S, E, W, NE etc. or specify the exact arrterrna azimuths) K. GPS Antenna Y /N ircle One) If yes, provide size, Dimensions and Weight: Note: If installing new antennas,show proposed location on the Water Tower,and submit this application with your plans and structural analysis. Note: Antenoa changes at water tower sites occur frequently...if you have a proposed location for the new antenna,the location must be approved by the City. If you have completed a tower mapping for this project,keep in mind that another tenant may be making changes,always verify with the city to see if the space is available. Note: If installing replacement antennas and they are larger than the existing antenna or if you are adding � additional equipment to the antenna mount it will require the Tenant to submit with this application a Structural Tower Analysis prepared by a Structural Engineer Registered in the State of MN. The analysis will be reviewed by the City's consulting structural engineer. Initial here to indicate Attached Specifications. 11. Dish equipment—Attach applicable specifications A.Number of dishes Dish dimension Microwave? Y /N (Circle One) Satellite? Y / ircle One) B. Dish type, manufacture & model no. C. Transmission line or cable manufacture & model no. D. Size of cables Number of cables E. Dish location on tower: Initial here to indicate specifications are attached 12. Are you installing new Transmission Cables (s)?Y / Circle One) Number of New Transmission Cables Size: Initial here to indicate Attached Specifications. 13. Ground equipment—Attach applicable specifications—No changes to existing lease area, however will remove and replace existing DC Power Plant and Battery Cabinet. A. Square feet required B. Location: ([nside tower, Inside Lessee building, outside) 172909�1 3 of 5 C. Number of cabinets Cabinet dimensions D. Number of air conditioners Air conditioner description E. Generator on site? Y N (Circle One) If yes, provide type, size and where to be located. F. Isolator manufacturer& model no. G. Duplexer manufacture & model no. H. Filters manufacture & model no. I. Controls used in addition to the transmitter/receiver cabinet(s)? Y N Circle One) If yes, how many? manufacture & model no. J. Is there a need for additional lease space? Y N Circle Orre) If yes, size needed for additional lease space? Note: Lease Amendments Require City Council approval. Attach any applicable information with your plans to include but not limited to:Photos, Cabinet Dimensions, etc. Initial her to indicate specifications are attached. 13. Underground. A. Is there a need to upgrade the existing power source? Y N ircle One) If yes, describe: B. As a part of thi roject,will Applicant be installing Fiber to serve its Communication's Facilities? Y / � Circle One) If yes, describe: Note: All utilities must be installed within existing utility easements. If there is a need for a new route the City must approve the location of the proposed utility route. A site survey will be necessary showing the proposed route which will include a legal description of existing and proposed easement. 14. Estimated date of proposed installation: 4/4/2016 15. Description of scope of Work (Example: Install 3 new radio units, relocate 3 antennas, add new power plant Install 3 New antennas with 3 new RRH on new antennas mount and pipe,new DG2 mounted on existin� handrail, 1 new FC-12 mounted near existin�FC-12 mounted on exitin�handrail 16. Estimated Value ofthe project.$15,000.00 (used to calculate Construction Permit Fee) 172909�1 4of5 4 PLEASE READ CAREFULLY BEFORE SIGNING The undersigned agrees and acknowledges that in addition to the Antenna Site Application Fee, the applicant is responsible for all costs associated with the applicant's proposed system that is to be installed on City property, whether or not the application results in a lease. Costs may include, but are not limited to the following: 1. Interference analysis and inter-modulation study by the Engineering/Communications Consultant of the City. 2. Review of construction plans by the Engineering/Communications Consultant of the City. 3. Review of lease agreement by the City's Attorney. 4. tnspection time by the Engineering/Communications Consultant of the City. 5. Site Coordination of any items (examples: antennas or utilities) performed by the City or its Engineering/Communications Consultant. 6. Surveying, if required. 7. Utility Service by local utilities to bring or upgrade electrical or telephone service to the property for the use by the applicant. 8. All required permitting and licensing fees. A certified check in the amount of$10,000 will be required at the time of submittal of the installation plans. These escrow funds will be utilized by the landlord to pay expenses related to professional services necessary for the review of the installation plans and construction (Items 1- 6 of the list above) by the Engineering/Communications Consultant of the City. Unused escrow funds will be returned to tenant at the completion of the antenna installation. A certified check in the amount of$467.54 will be required at the time a completed application form is submitted for a City Construction Permit. Signature: . � Date: �^ � ` � (Authorized signature from wireless carrier/ lessee) Name: SG�I V(��() Title: � � �C�iulSi'�r?r� �Cl�ti �/S� —v Telephone Number: � ) � ��D �O��e-mail address: v�/�1i1 C�S �_�f�, (c�.-�� Provide a letter of authorization, if you are representing the wireless carrier/lessee in this process. 172909v1 $ Of$ ! Checks make payable to: City of'Orono Mail to: Ciry Contact City of Orono Adam Edwards, P.E. Attn:Director ofPublic Works/City Engineer Director of Public Works/City Engineer P.O. Box 66 aedwards,cici.orono.mn.us Crysta!Bay,MN 55323 952-249-4661 172909v1 6of5 February 29, 2016 Re: Authorizing Black&Veatch to Represent New Cingular PCS, LLC(AT&T Mobility) To whom it may concern, This letter is intended as authorization for Black&Veatch to represent AT&T Mobility in matters concerning the upgrading of telecommunication facilities in the City or Orono. Sincerely, � ��_�_____�_____ � - _- '��____ .i' l Janis Delins, BS/MS Engineering, MBA Project Manager AT&T Mobility 901 S. Marquette Ave. Minneapolis MN 55402 Desk:952.229.9656 Cell: 952.258.3192 E-mail:jd799u@att.com / . , �, DATE TIME CITY OF ORONO CALLED IN INSPECTION NOT CE SCHEDULED PERMIT NO. � � ` �%E��`�- connP�FrEo ��- � % � ��d � ADDRESS �—� � "�°� ' v OWNER �� 'C�''��' TEL PHONE NO. CONTRACTOR �� I�E��C � �C��i��'�'- �; DESCRIPTION 4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP � ❑ BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: o� W a 0 , /C"��' � �'� C�� L�C� u/G�c^��'� �. � O � W � Q � Z W � W � J a W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ IS E CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-46�0 OwnerlCon on site: ,, , Inspector. - =� ' i White Copyllnspector's Ffle Canary CopylSite Notice