HomeMy WebLinkAbout2000-P03096 - remove oil/fuel tank � .
PERMIT
C I TY O F O RO N O Permit Number:
275� �Celley Parkway - PO Box 66 P03096
Crystal Bay, Minnesota 55323 Permit Type: �vtechanical Permits
(612) 249-4600 Date Issued`. loi9i2oo
SITE ADDRESS: 725 Ferndale Rd N
WAYZATA,MN 55391
P I D: 3 6-118-23-12-0002
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Remove Oil/Fuel Tank
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 1,525.00
State Surcharge Fee: $ 0.76
TOTAL FEE: $ 35.76
APPLICANT: MAYER DISTRIBUTING OWNER: M J SOWADA&M B SOWADA
P.O. BOX 6221 725 FERNDALE RD N
WAYZATA, MN 55391 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI� REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
/
f rP�� ��,�/71.-ePNI
- ;�
APPLI T PERMITEE [ NATURE ISSLIED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
� . -�� �M� �� �173 -5�.8�
'�
CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within 2 working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL
YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON
THE JOB SITE.
3. 1�lechanical Desiens - Complete calculations, details and specifications are required for each heating,
ventilation, humidification-dehumidification, and air conditioning installation including heat loss/heat gain
calculation, design temperatures, equipment ratings and identification as to type, manufacturer and model.
Data shall be presented on form provided. Identification of and specifications for water heating equipment
shall also be provided.
4. When any new construction or remodeling is involved, a separate building permit must be obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements.
6. All work must be inspected (rough-in and final). Call 249-4600. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600.
Please check one: New Addition Repair Replace
�/ Residential Commercial
JOB SITE:�i� 5�w,���. Zip:
Owner's Name: �", Kc� S,Aw�a�,� Telephone Number: �,� y 7c� .-'1`I`13
Mailing Address: '�Z.� N, ��,�,s�,� City: c��-�.`c; Zip: ;� -��,_
Contractor's Name: ����R p;s�;b�i�,,,_,`_ Telephone Number:
Mailing Address: � �_��-��� City: �,�z,4�.-� Zip: 5�3g �
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
- H. Power
. �
FIREPLACES
Gas factory fireplace
Wood burning factory fireplace with flue
Wood Stove
Wood stove with flue
Brand Name Model No.
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath E�aust (must be ducted outside) cfm
No. Other Fans: Locations cfin
FUEL STORAGE (MUST�E APPROVED BY FIRE MARSHAL)
Installation 1/ Removal
_�Fuel oil: gallons underground inside outside
LP Gas: gallons
Other �„�,���,5,� 3___2����� Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
�Sa.��� x .0125 $
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
or $.50, whichever is greater (contract price)
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
work including materials, labor,profit, and other fixed costs. It is the amount to be charged to the customer
for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or
any other party the reasonable market value of such items must be added to the estimated cost or contract
price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may
request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater.
For valuations over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
VV1�'�.� � �-7 l
Applicant's Signature: �,�! ��Q�S���.,��,.. � ,,,, � �---� Date: /U-Co '-c:�C�
Approved By: Date:
:- c __
_ - - _ _ _ - _--_
�i�i � � — _
%f:s� !'�,�'si��r ���'�4k4s`�}� - ��' ��� �� ���'t1�lf �iltf'1`���t': �,i���,.��
L.f'y�i�! ���, ►vi{t�i��St3Ec ����� �'��'�'ili� T}f��; �,ecl�an;,�ti Pert,?it�
+;t�i�} ��4-�`r"L�L# ��'�v ��e�.!t�£�: 1'�'`� =���
'r ;
� �S1"`� �al������; ,� ;n��.,�e 3tt?� _,.._...�.u._.�.._ �.�.._.
;;7c i '
`'r�'':14��a��=. °�1l 1� � � � � � �i
� C'IIJ. :�'-i !�'..�3'!� �1(s;�1� i'
��� S.t��6.dF�@T'�[�.1fYo � � � . � . . -!
� . � � . . . . . . . .. . �. . . . . � . . . . .
ty..��11;c ' i`:�: �Zc:=ku�i:llE�;
. �.�L`.-!'li'; �,!}?;:r:: � � �iii��T3� �. � _ �. � . � � . � ... � � � � ..
l � � t't�,nit Sui�-t}��ctsj: ��e�3�� ��i7j3.'l�t�;:I 'i��.3k � '�,
�:'.'^?i; 1� •t': i�.ftt'�ic.il(C.i� T'ct'fi1iT:;
����S��. ..�......,..�� ....,._m...o.._....,.a �.�.,,...� .
�
' n�'�SiC�tNi� C`ft`CE'yiliElIiC�CI r:
� �'`Cf3:s�'�t�t3�trii7l:�:::t�lLi?I'k'C�: � � � �
�C7����.�l��i'���.��4�:
; ��,�^�����AF�Y; ._.______ 1'�r���it i���;: � � � _;�.t�t� _.___._._ - M _ �'.�[t:ation� � 1,_'�-Cit�
� y�K�:i .71in� 3�L.�::.4 �31S,1�:. ,'?, 3�.Y!\j . . � � . , �
' '�'ttT:�,S F�'f': �= 3�,'��: -�
�.���,,.����`��: ?''�'�Y��:<I:9tS!Rii�t.s'i i`r�Ci _�._ _ _.._. `vt J 4C)t'�:.i�."�� itii Li ��i�'AI?:a -- __�n�,.�_
�����.'
i.C.;y g?'..P°4 b";?? ??�; 1�1��Z.'ti[;�:�`tl': Rf1�'
� ��":��.���:�. �i�'� Jti_"�! ���.•"1�L.�S.�i��'1_� �9_)�] � .
��i�F: "�.::�t..I��tiC=;',��z.� i-;l:E;�:l�1' �.�:,,t;��;:� i'�it":]I:�SI{):; 'iC?�;.•4�:�� If�t °ttn:`•.t� ic:°�s��t�:.\iE.`���SStJc:r�feif�.L
i l'�I:�1:`:osi,�F�S';"�` A.,;;.•'�4... 'a���?�;�i'.� ��;�3C: i c:C'�iI'l.:4."�;C i: �.1`I t':�?>_� i ;� '�:` C't C::1'��:�{:`ftl�;`�;�1�C_�� :ti�:?i
�'; a_r; ;:' 4 s`t:<'e ti�_�i�_8 �t:'�.C'��"i_:C't�i's!-. i'xMt�?l'IRI•.'of6�":"t�.
' � � .' /` ,l� - � - . . . - . . . . . . . .- �- � . � � � .
I - ' ����+•�' . � ,��� �� e k��� .
� v����
_�.._...�"'1�':'. .C:111'i'i . 1�i �� 4i�'�.�.€ t�. _.. : i�§l'?.�:1is1 �Z�.�'t��E'i4t: ...._.m.a.,
�� l � � 4��
�
�'���!i��: s�!f`., .%-1�'+7i1C:::t?L. .4.S5�3St:�, �`i1::;.i'EL`'� €'a�'� :
�
i, . . ..: . . . ..::. . . :.. _ . y wm,ri. .,�„1
i _
� ���� �� �����
,t
e f e� ��iiP�r P�rk��fat> - �Q ga� �� ��rmit ���n�k���': g=�,,,.,�,;;
C��'�t�;; ��t�, �4�l;�t i�s�t�� �5��,�
=r�'��r ��e;'����` � � :t: i�.'t;U�a r
L.� � $� 5��;��:
_,__ __,..� _ __ j
' ��`C� ��$�����' %�i F�rn�d��l��cf �
��'.•��',�:11:1.:�1'� :�?';+�
���€�BCr���`: �:
\1A�'�:1�DiaTRIBL�TI\G ,��
`t'�.ii. i�?�i:i t7�?i
I ��i t=.�i.f rk�. . .`4��°� ''`;;�,
i�
5 : '
4 ils=C l{ 1;�4;. t�i'.413't�rl�i� . . �.
-�. t f
. i ��ru�i .r�i1 � �i41`i.�ii;VltV�.�i;�)!t )'l3f:f t slTPti
�'C!`±'I'�i t_t.i�5: �_�::4i�.:Y;zt
,s',
� � _ .,.:;r.�7'��pc: '�t��iz.t.zii���l 3'i:-mit:
�
`�:�`":'Fci�i 13i�j; �Llt`•i:, r:'iyfd3l'Cti. �
�441fe111#1'r_ �sCitl`i':t�: ..:.�!I,li�:lk ' �C�tFtJ. ���::��<<ffii �4� i'iti�ii
,
-,. , . -....,>. ..,� ,,. .�, .��_ : . . ._.,, �� � �_a•.
... :. _e.: -.�,.... �. - . .���.-� _ . - _� ._� .�,: , ..,d,s,� - - -
. � 4�., .;�, �-
� -� . -�- .�..r - .�
„
.. „�«,�_ , p �. „� ,�..,�.. �..a u�-� 4Po.. ,.� 3_-.; ��� n .. ,,, �
�x�t1IT1�ilE1!„*„.
I
...,-a--•--•---^"_„�. ..�,a.. T ,,,..��
., . s ; 2 .w.a".'�,...�
� �
.. . r ;, . . .
., � ....: .^.,. .r..
,,, .... ..,s
...,.,,.e -,�....e.....�.,..,,w:.r._.. ...�o.m
;: .
... . . :::.; �
.,i_.. .. . ,
, � E i j l
, j __�...�...n,..._�..s,._._._ s.,�..��.._._. ...�_. � ._...,.�.� d _.._�e.,.___,__w.�, � — �..m...._.w._...�
�, `. , ! ...�.�._ ��.
' � ,.m.F„_.�..__�.�....w_ ` _�_.,_a_.__.._.�,.�___ ....__�__.__ ______.��._....�.�.� f __�.�_�_._.__.__.
r �.� } _ ,.,.
; ! � � � �
, j.a....�...�� _._....�._;...�._.— —���_..e._� s �.___N__�_._�.�. __.�.�. —.�....�.___...._._..�..._ ° ......�____A._..,�.a,.��
... ._.._..��..,m.._.
' ° � � f � I
��._�_..._.o._._.��. § ��_. .. �_���..$�.._....�._..�..��¢
� � p " , � i
; �.__._�.�..�..�.�.w.�.. _.�.._..�..�.,.�.�.__�...�._.._ � _._ � �.����W_.�..� � �,�..�..�� �
1 � .�..� ,�.�,�.., �
, � -__.___.�.�...'.. -- � ..�A.�_r.�_�.�;___..�...��..��___.._���.��....�_�.
: _ � . . :. . . . c.l S ` e, o A'+ ; 7' �9' *,{1 i< qi -�� .7 r..,.
. � i. _ . r... .�. 'a l. ..A\
:,�.I, b:��i-�_:; 1�1t�°tia �,it.�i ;_:��. �i_�.i:�� 2� 6��s ;t.� ,.�, ��.�a;�� 1.«. f, � �. �� '�, t,�_. r�,,��t�t.i'f s�.'�
� �i_?\�t';i ��c�['� i`�,:�C'): ���; "i}:9: E°IZ�::�t1ti�;� ta:�t�'�:�tCE�"tl3t:,.,"c'(:i: l,:; '�t. �;R, t,(�,�er'.
i
�:,... , ,�_. ..,�: .. . :,,..... . ,,. :�..:..:.,.-„�. �, ..::;:,., ,. ....,.�a. r.,,....,. .: ,, .. x;:.:::�. ..�,::.aG*�..a.,.,,:.:..:v _........s„�_,.F__..._e.e,. .sw,.a..,.....�..,.�av.-..,..��.,�.a.av �m....:ss-u.m+.r�,..>e.wn_,,.w�..o.k�.�.,Yr.,a,�o�rs.�a.�,.
�
d.b.a. Mayer Distributing
P.O. Box 358 612-473-5488
Long Lake, MN. 55356 f�: 612-473-3045
Invoice Price
For : Mike Sowada
7251�1. Ferndale
Qrono, Mn.
Proposal
Products & Labor to be provided for tank removal:
Permit $ 5�,��
Pump out Fuel and �isp�se. $�
Excavation $1000.00
Tank Disposal $ 225.00
Total Cost of Pro'ect 1 275.00
Mayer Distributing provides permit and all paperwork related to
hazardous material disposal and tank foaming, including inspection.
T�ank you for the chance to serve your needs.
Jon Mayer
Mayer Distributing
� �
L �
D P
T T
O O
NAME TELEPHONE( )
CUSTOMER P/0 DATE ORDERED DATE COMPLETED DA7E SHIPPED VIA INVOICE DATE ORDER NO.
�- �- � `'� �U Q�
WRITTEN BY HAZ BID 5HOP FIELO
, � MAT YES NO METEH REFUR
�. '� � iy"f+ `t :.�U `.-e./ /� �ftr�� � .f � �� �` " � ._T � � . . .
/
��..-� J
� �� � � � � �
!�/
{
� t �, � _ �' _ �� ( �` � '�� �' � 1� �
( � � �' (7Z" -' ��- 1`-'`" � � { �. �' ��i-
_. _� _
� � - � L°
�
t
v� �� �
�
,; :
QUAN REMAINING MATERIALS NEEDED FOR JOB EQUIPMENT CHECK LIST
FRESH AIR EQUIPMENT
PUMP&HOSES
AIR COMPRESSOR
LADDER
100 GALLON PROVER
1000 GAI�ON PROVER
DETERMAN BROWNIE,INC.
DETERMAN BROWNIE INC. • 1241 72nd Ave. NE • Fridley, MN 55432
SHIPPING MANIFEST
f. _ .,�'._ :}-,
Date:
Work Order.
Bill To: Transporter:
, ; ,f 4 : ; ;r. � , ,�- DETERMAN BROWNIE INC.
i` 1241 72ND AVE. N.E.
MINNEAPOLIS, MN 55432
SITE EPA I.D. No.:
Manifest No.:
Lletarman to Com fete
Truck Date Checked O#ioad
HM Gallons Product Descri tion No. Received In B tocation
GASOLINE 3, UN1203, II, FLAMMABLE LI�UID .
,", � FUEL OIL 3, NA 1993, III, FLAMMABLE LIQUID
PETROLEUM PRODUCTS, NOS, 3, UN1268, III
N/A USED OIL (NOT US DOT REGULATED)
Pick-U PoinUJob Site Destination
DETERMAN BROWNIE INC.
, : F ;,, � .� � 1241 72ND AVE. N.E.
� MINNEAPOLIS, MN 55432
The Generator is responsible for the cost of the analysis and disposal of the TRANSPORTER CERTIFICATION—This is to certity the above named materials are
above named materials in compliance with State and Federal regulations. ¢Foperly classified,packaged,marked,Iabeled,and are in proper condition for
GENERATOR transportation according to the applicable regulations of the Department of
� Transportation.
NAME(PRINT): TRANSPORTER NAME(PRIPIT): �' `
SIGNATURE: TRANSPORTER SIGNATURE:
POTENTIAL HAZARDS
FIRE OR EXPLOSION FIRE
Flammable/combusiible material;may be ignited by sparks or flames. Small fires:Dry chemical,CO2,Water spray or regular foam.
Vapors may travel to a source of ignition and flash back. Large fires:Water spray,tog or regular foam.Move container from fire area if you can
Containers may explode in heat or fire. do so without risk.Apply cooling water to sides of container that are exposed to
Vapor explosion hazard indoors,outdoors or in sewers. flames until well after flames are out.Stay away from the ends of the tank.
Runoff to sewer may create fire or explosion hazard. For massive fires in cargo area,use an unmanned hose holder or monitor nozzles;if
HEALTH HAZARD this is impossible,withdraw from the area and let fire bum.
May be poisonous if inhaled or absorbed through the skin.Vapors may yyithdraw immediately in case of rising sound trom venting safety device or any
cause dizziness or suffocation.Contact may irritate or bum skin and eyes. discoloration of tank due to fire.
Fire may produce irritating or poisonous gases.Runoff from fire control or SPILL OR LEAK
dilution in water may cause pollution. Shut off ignition sources;no flares,smoking,or flames in hazard area.Stop leak if
EMERGENCY ACTIOIV you can do it without risk.Water spray may reduce vapor;but it may not prevent
Keep unnecessary people away;isolate hazard area and deny entry.
Stay upwind and keep out of low areas.Positive pressure setf-contained �9nition in closed spaces.
breathing apparatus(SCBA)and structural fire fighter's protective clothing Small Spills:Take up with sand or other noncombustible absorbent material and
will provide limited protection. Isolate for 1/2 mile in all directions if tank,rail Place in containers for later disposal.
car,or truck tank is involved in a fire. Large Spills:Dike far ahead of liquid spill for later disposa�.
CALL FOR EMERGENCY ASSISTANCE: FIRST AID
1. Determan Welding and Tank Service...............................612/571-8110 Move victim to fresh air and call emergency medical care;if not breathing.give
2.Rick Anderson......612/574-2392 3.Gerald Krob........612/429-3439 artificial respiration;if breathing is difficult,give oxygen.
4.Jim Determan.......612l755-3740 5.Vern Peterson....612J241-1880 In case of contact with material,immediately flush eyes with running water for at least
If spill or water contamination occurs call: 15 minutes.Wash skin with soap and water.Remove and isolate contaminated
NATIONAL EMERGENCY RESPONSE NO. 1-800-424-8802 clothing and shoes at site.
WHITE-WORK ORDER YELLOW-OFFICE COPY PINK-CUSTOMER COPY
• _ - • � � removal
"� '"a 4 �a
� �
- �, ��, °a ,�'
i�+ ,,.
bi " � '��
, 4 �� ��r, , `,
�
- .�
� 1 ���.�
,
r ;' .
, ;�.
��
�.,
'. �`
�
. '�:
,�.`
, � '•' a' ;- ,,��; ;.
F X` ��"; ' • `:� "�`': .y' �
- '� :'��,i '1G"'`�"^y1.;.. �� � "�'�" ^�.'W�
. .. � . i �� F� :���
d'- ��
,�N�� soii contam����� . �� w� �''
,. $ . ^! . b . -1� 'J . , ` . . ""�ao-�. i g
Page 1 of 1
a� i . . � A�,! � ..., F.
.� .. � . " ' a ��V�y � �
,
,. �as
�, � ;� fi;� ���;:
� �"� `�� �l��',�! ��� �<
y r�
�� �� �.��� �, � � ,� � � �'"� ° � �.,..
i� � � � t ����. �
��� q` �� ���� � a � �ks'�v � � . �i�+ +�y�� � l�'�y"'y�`` 7'��
� �°�r.$ � N�� �;�... �?� 1 ��+zN,�� pd�` ro �n�,�, ,�., , �
5 '�� r'=� rr�{�. 9r ��
� ;4� � t S � ' �� '*�`� � ��.�'k �
� , t 3�N � �. 1�� c t� .. . �'{�; ,., . �: - �- '�� ��I.
?. x� � r 9 "'y se' �'Y�y�„�N� q
^i3 3�"� 'S�� - �� A�s�.�
�t ���. �:. ¢� i ,p�`�x U.�.,� � k' ',d �^ �''��,�_ w �.,Y°oC n . �nR
v fi {e�`� �,py
la { ' 4
� 5 t." f x : d ;✓.� �, ' �µ
�. Y. ,��„`�� a 1 } � ; .�r��-�
:Ps n� y�s 3 'v� "
��*�s M'�.. � 1'fi�"4�� M ��k�� � 1�..
�� �; ., k� Y S,� 'O`e �„�� `�J'T'�MiR � :,
1 � �`��
i�}
:,� �.. � i L�i�,!� S ��� .i � wi
�. . �r��T�f ��� � rp���� A� � -« ' � ��,�
�� � `� �*:� s�, n
KX� 4�a�y�.,�f � � �
k5Wu'a�� 5�
Q 'wA^'6��1h���''��� }�' . ..-y .
�a I ��� � � ..
..�`,�,�,� g s �
.�-�� � u'� �'^�� ��� �«w� „a
,,,.....y * . .
. , � - _ "p., �, ..
, � >-
. . . ' - .. � . . �i.� 7w . _ .
�
., �
�". - �. � � <� � ,�, �, � . .
. , _ ., , .. ; .
. � Y�' w�M��. .: . , � „` . _ � ��"�1 .
. . '£ � ; " i 'r, 'P,
� �, ��. � _ .� �., .
. ,�
'+pi�M a . = . . ' . . ;
s�,. � P �, _t �: �I .
�� � "'�=�� � `. �, .;�
� � ��� ..,�: �' �` , �� `�
� � � �
�,
�, , � ... �: � � � ��,.ds .R..
'w"": ��', ���k,:- . �'��w.,;� f*�; ;�� ,� '�.' , t.,'�
� ,
'_ _, � -
",, . .�+'�. „ ,' , - « .; . P �` _
�, � �' �
.,, w _
� .� ,
2 ernda��e�� ��►�:* �� �C`��k r+�r�o���
?` 5 � �� �
�a �, �
file://C:�Documents%20and%20SettingsVoman�I,oca1%20Settings\TEMP�IVIVC-OO1S.jpg 5/17/2002