HomeMy WebLinkAbout2014-01318 - addn/remodel/repair . , CITY OF ORONO * Z 0 1 4 — fd 1 3 1 8 *
2750 KELLEY PARKWAY DATE ISSUED: 1ll24/2014
ORONO,MN 55356-
952) 249-4600 FAX: (952 249-4616
ADDRESS : 3669 NORTH SHORE DR
PIN : 08-117-23-34-0051
LEGAL DESC : CRYSTAL BEACH
: LOT 003 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRiJCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 14,961.80
NOTE: SEPARATE ENCAPSULATION
APPLICANT PERMIT FEE SCHEDULE 265.50
PLAN REVIEW 172.58
COMPLETE BASEMENT SYSTEMS STATE SURCHARGE(VALUATION) 7.48
54004 LOREN DRIVE
MANKATO,MN 56001- TOTAL 445.56
(507)387-0500 Payment(s)
Minnesota State License#: BUIL-143377 CREDIT CARD 9982 445.56
OWNER
ETAL, WARREN BERG
3669 NORTH SHORE DR
WAYZATA,MN 55391-
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 governing this type of work
shall be compied with whether or not specified herein.This pertnit 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.
� /� / Ci��'�'v,�- � � � z�/�
Applicant Permitee Signature Dat Issued y Signature Date
Ci�y of C�rc�r�+�
Building Permit Application far Maintenance / Replacement I Rent�vativn
(No structural expansion. Only windows, doors, siding, re-rc�of, etc.}
Matling Addre.�ss: �� _ I�I '
�-y�'�-���� � PO 8ox 66 ' F'ermit numbe�: t
� ' Crystal Bay,MN 55323-C}066 � Uate received: ��-'�v—�
� Stre�t Address: Received by: �,�/�
� � � i 275{?Kelle Parkwa
f `t f x .�. Y Y Pian review tee:
�. �y .��� �`�.�� t3rono.MN 55356 �
AFiNI���.- �
�' _ . �rD��c��e: C � _ cj�
Mam: 952-249-460D �ax: 952-2�9-13616 ,n�ww.ci.oro�,o mn us �
__ _ __ ' _�._.._.�,�.....�___._. __�/rG�__..//-�/
This applicatian form must be completed in full and al1 required infnrmation must be su mitted.
{ncomplete applications wiil be re#urned. (Piease prrnt)
GENERAL INFORMATION:
�� , � `"
Jab Sfte Address. _ j � � ��4 '�.� _ � , r �;° °,��_ i_� �. �_�.�;
Wiii this be a Parade of Hames, Fiemodelers Shr�wcase Home of other Display Home? ��]Yes —�,No
Il yes,a spa�rat event permrt rs requrr�d with f�otr`r.e Oep�r(mer>t ttnd City Counci}approva!60 days priar Co fhe event. Shuttie bt�s senr7ce wi118e
r�quveel unte:�s applicanP ciarr�rc�nstrafes sttNr'ei±�rrt an•s;le parking is avaitable. Non-permiited sv�rrts rvilt rrot be allawed.
CON?'RACTQR J APPLICAN'C INFORMATION:
Name: ` � ` y
:k � �.— j c i � � '.—'.. .._..� l'. \ . t,,,�\�. � �I L.� �'- __
State �icens�� • - ��- � " �Expiration Date: �,- '"� � .� �(�
_�_ ._,. �._ �_ __._.. _ , ..
Lead Certitication Nuniber ...�� r �',, _�'�i__; _ � ExpiraCion Date =� - �j�, • � ��,,� � ,,
(for work on hames that were constructed prior to ?978 _^
Phone: tceli) �__..________ (office) ��;� -` ,; - ,'��; � , -� �`�. <:t��
Mailin Address: �"`.r..^ �; � � - � • � r � -�-��
9 , �i�[ C 7 �� � C�� �t- u � l 1 r �L-r City: �'x���;� a��t�,���>ZIP: ...�{_i��x. _=i
Contact Person; -�����, ��t. ��-,<;,. Applicant is: �c�ntractor °H meowner �cko�o„��
Emaii ancJ/ar Fax: ` , , ��� ,; , t �.,.� �;t, � -._. ..
c r .. l�:�::15:_.Ct..t� � ,�'� �`�
� �_ _ __._ . .��°r��,
i'Rt�PERTY OWNER INFORMATION:
Name: �� x��_::_.°� -`---_� '�
Phone (day): 1`-� � �-t��_._�
..�� �1,.
Address: ' ! �� ��d � � - �' Cit ,����,- t.,�.. ZfP� ��"' c�: �°��-
,- ._
_�..����...._�.. ��� e •�;����:� 1..�'1 Y �1,��i� � � _, _3`�1
Email andlor Fax:
PRt?JECT INFORMATtQN: �verail pro�ect description: ��� ` ;��� �,' #. , �> � � �, �. �,: � ��. ' ,�..,:� �� ,, `, ; � � ,'�', �"�
_____, _ _----
____
Type af Project� j Any earth movem nt may a4so r�qui�e
MCWD review& err�rits.
I p
; ❑ DoorCs) ❑Remor�di ❑Fire Damage �
� ❑ Re-roof,asphalt �Repair ❑Storrn Damage � Minnehaha Creek Watershed District{MCWD)
� � 182(}�A�linnetonka B{vd �
i ❑ Re-roaf,cedar ❑Restoration ❑Waiar Damage ; pe�phaven,MN 55391 �
i ❑ f��-raoE,ather(specify) ❑ Siding ❑Other:{speclfyj � �hone: 952-471-0590 �
Fax: 952-471-0682
; ❑Window(s) www,rr�innehah�crQek c�� �
�_...._.___ _.__.__ --..._______ ___ ______�__._..,,�..__.__ —_,__�
Estimated Construction Valuation of Project{excluding land) $ ti-�,�^,�2';•`�ut`
APPLICANT ACKNOWLEOGEME#�T;
• AUrees ta;�rav�de ail inforrnatic�r� requir�ed or requested by the Building Department�
• Certitios that tha iniormacian suppiied is true and correct to the aest of histher knc���rEedge. The applicant recognizos that they are
soEely responsibfe for submitting a complete application tteing aware that upon faiCure to do so, the stafl has no altemative bu1 ta
: reject it uniil it is complete;
', • Some or ail of the information that you ar� asked ta provide on this application is classified by State !aw as either private ar
' c,onfidential. Pnvate data is informatio�which ge�eraily cannot bs given to the pu6lic but can bo giu<sn to the su�ject of the data.
Confidential data is intormation which ganerally cannot be given to either the public or tt�e subject ot the dat�, C7ur purpose and
( intended use ot this informaGon is io annual(y update our records and records of other gcsveenmental agenci�s required by law. If
� you refusa to supply the tr�formation,the appGcation may not be issued.
Applic�nt's Signature: �" ; ' `� � �' ��� i �! ' 'C:_ �. ����'�� , Date:� } �, - 1 t�'� l �.�
Owner's Signature: Date:
Last Up�ated:03r0612013
. ���� ���E��:� �C���E����°� �O� ����' ��'�C���'���� � �����8�[��
Ac�d�ess/Pe�it 6�e�mber: ?6 6�1 N C9fZ T]-�'S�f tUf2� Y.�2'�ve.,
ETescriptioe� o��.4ortc: (�,dtt44..s�S,Q�C� 13 �r C.4�5�c.�-rt�
e
Septi� revieiv by: A1 I�A Date�4pproved:
, Zor�ing review l�Y� �� Dat�Approved•
Building review 6y: D2ste�4pprovect• / { ' J $ - ?�/�
Gr�dir�g reviernr by: N�/a Da�te Approdsd:
Zo ing Di�trict: Zaning Fi[e#: Re�o#: Re�o Date:
toc�in . Lot R�: SF i AC �ic�th: Lot Covsrage: SF %
Survey�u ittecf: G Yes � No Date of Sun�e�+: Revised date . :
Pto ased Se acks•
Front(Lake� Rear E�treet) 6 � �i�� � ) ( � �i�� � ) Qt6�er Bu ings �ite#land
Deflned Hef��t: Pe�k f�eEght: FFE: F�E minu feet= (Exist6ng Contour
PBr�rneter(6inear feet)= 509�0= #of S�ori Ok? �YES
EOR A BUILDIAlO W!'i�!A BASEWIEkT OR CRAVYL ACEC
the distance between e 'st FOR IiILDING ON A SLAB FQUNDATION.0
START WITH preposed Boor(of{he basem t or crawi
space)and the hlghest poiM of roof. START WITH T�distance between trie top of siab and
If you have a... the highest poi�of the roof.
• CaABLE OR HIPPEb ROOF(n0 �f you;heue a...
' window8): SubtraCt half the • GABLE OR HIPP�D ROOF(no
distance between ttte hi hest , windows): SUbtigct fiAi�the dist�n�
g poinT between fhe highest point of the roc
of the roof to the iow point of tMe to the low point of fhe cortespcndin4
SUBTRACTION c:orresponding gable or hipped SUBTRAC710N gabie or hipped toof
�BA EED ON ROOF . GAgLE OR HIPPED ROOF( ' (BASED ON . GABLE.OR HIPPE4.ROOF(with
� vNndows;: �ubtrad half the ROOF TYPE) windows):;&ubtract haN the diatenc
distanea between fhe top the between`�e top of the higlYsst
highest window and the 9hest window and the fiighest point ofthe
point of the roof roof
• ALL OTHER RO TYPES-(flat, • ALL OTHER ROOF TYPES(flat,
� . mBnsaM,et¢): subiraction. mansa ebc:Mo su�ra 'c�.
AD ION Add the dis4erace between the top of siab
5ubUaet the dia ` 6etween fhe
• SUBTRAGIION � (BAS ON and the higheste�4tstinp grade adjaceM h
basementicraw pac8 floor and the
(BASED ON EXISTING �ST�N the faundatlon.
GRADES highest exist gcade adjacent to the ��gg
foundation R 10 feet(wivchever is less)_ E�IUAL Deflned bu(Rding height
EQUAL8 D6fi ild(og height
Shcrelanc� District �C1�Q P�rm�t Received Rveca e L�keshore Setb�ck�fiet? Bluff
� Yes � No � N/A Yes t7 No
C� Yes C7 0 � Yes t] No Q N/A
Permit Number. Setba :
S�a�m�v�te t�a�li� Existf�g �p�PQs� Varianae Re�yic�d CUP Requirec�
Overi� �t�ic�Tier l�ardcover li�rdcover
� Yes � No � Yes CE No
TYPe(S)' TYPe(S)'
Updated� January 2013
v:\formslplan review checklist 2013.docx
REA�IARiCS (in-house):
Fee�to be Cha ed YES �'�
Rer��
Plan Revie�v
St�l�Sut�C�rge
Investigation Fee
$�aG—#�mber of 8AC t��it�
Other(specify)
S uare Foota e S r S uare Foota e
Basement x $
1°�Floor X $
2"�Fioor X = $
Garage X = $
Estimated Con�trwction Vafue: �y g�b� •�� ��
Orono Inspections RequirecG Vliork F�ec�uicing Separate Permits Requit�d State Permits
� Site � Piumbing � Grading/Filiing � Well
� Hardcover Removal � Mechanical � Fire p�'Electrical
C( Footing C3 Septic � WaterConnection
O Poured Wall � Fireplace � Sewer Connection
CS Founda4ion S�rvey 0 Masonry � Lawn irrigation
t3 Radon Rock Bed G Mfg.
C! Framing � Other(specify)
� insulation
p As-BUllt Surv@y
�Final
� Wetland Buffer
Q Other(specify)
REtw'IAF�K� (in-house):
Oth�r Reviewr: Reviewec� by: t3ate A�proved:
Access: Existing: � YES � NO New: B YES CI NO
CBFFfClAL RE�ARKS-T� BE I�OTEE1 ON PERMl�`���iNETEALLED
Updated: January 2013
v:\forms�plan review chedclist 2013.docx
Monica Fadness
From: tricia@mycompletebasement.com
Sent: Monday, November 10, 2014 12:24 PM
To: Monica Fadness
Subject: Building permit application
Attachments: img 11102014_0004.pdf
Monica,
Can you please submit the attached permit application.
Please contact me with any questions and for payment.
Thank you,
2'ricia �iNoitas
CompCete�asement Systems
1�"roduction I�epartment
54004 Loren I�rive
�Kankato, �iJV'56001
507-387-OS00
www.MyCompieteBasement.com
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� �omp{ete Basement Syst+�rrss � � ��� � � �'�
Ryan Brenner � �
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* Your Bas�rnen!Praless+on7t �_,��,��,� , ��,} Q
„ �:y www.MyGomp4Qto6asement.cam uH�/L �.l
i > (800)638-5285(612)916-1'i87 �� !��iJ
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J08 LOCATibk 3689 Narthshare dr Wayzat�MN 5539i CELI — �
FN: — �
;; Systam Features �
Wai rGuan_� M���creHk-Mai2a�ry APpROX INu7ALlAT1OFJ DATE;��k..y�( �� �
w:�t�r:f;uard Part rlr�w Mattui� APPftOX CC1tviPLET1C.5N OATE �
� . . . . . . .. .. .. ..... �«�.nr.v a r�anaca a.a++•ink�
T�er�c,hCJt"am Rt�ir,i lrut�r . . . .. ... . -
. . .__. .,. ,_. . � . _ ..___ ...._. .. �
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Uiu;aSum�r . .. Basamcnt Winao+v> .. .,. ,
� . . . . . . . . . ...... . .. .. � li`.
�ir�uard �.f ver�Lafit'Nindow tn�rf `�.
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�' LawnSra�e!Oulte� ' Sunhe�us+3[i'nGtx�a�rg5 ' . e ;
� Fkxitii.9mrk WOUl�a�KWm;7�vUram tn"�';�-�•"�•,'"�,''"�,'�".'.�•.'�"-�*�. h
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i3r�r,.,,htWali S�r.i(,)ry(:X tur Syit�etn r�. � ``� �, � ;4u.�a, �z. �w.j »..�j _-. -�.
pTl��rnalDry Wal!Sy�ie�+n � . . Sa�Dry Duets � ... �. . '� �•��%� '�¢. ��'� �•y�v�. �y,:• y��, �tt. �.
` . . . ...... ..... :.. . . ��SMc�"3t 'tla �rt.wP �'M�+_'R'R�..{ �
ClearSpaa�YJall Syslem �-CkyTruk � � �
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i� W�rll Resioralkv� � F%latxl5l'�an Fuil4Vaif ... _.. .. �� '
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f
g Basemnnt in ESeaut�tui f>an�8s ..... . Eztn F9umtnrg ��
,. .._...... ..,. ._.... . i
� �.�Everl.as!Wcatt F�rxds . . .. . Ranon ExtnrKar . .. . g.
� . . . . .. , . ._.. .._�_ .__.:_...... . . `'�
� Ce+�nc�Presuge 4nsnF;��t(SF) aeraufn aanvwKc anqcH�o �
� Ceiknc!luwn � . . _...... . .l2a�cu�Imennr... . . ...,. _._.. .. . WB�f0(JQS@ ��,
� ..... .. . ... .. .. . ....:. . . ....._ ...... ... �[f Ft1N9��1lIAiCNtlll�{1:iM rx}M�f.t u�IaYi'!Y(ISfh:e��wtih BtfOup �
E Car�st Ch¢�rcoat Extra LawnScary�(lF� 25 +
"��` . . .__.. __...., xf+����tetttxes.4orvtvn sun.�' ; � �
?rle 8e�o �F�Y t oem.'�"C�q.Ft} ,j��`,,
� Td�e SancSstortE: . ..... . .. . �Pcrwe{Hracx�sft.�t ... . ... .. My�3SEIT18i7t pTFGE' � rJd�.QI�
� Car;7atMceha Ck�mo(lF� {L'�+��!'8W�5�taCe PftC4' � �4+161.$0 ����
� r�{��''�v���' P�jRTMr _ . Total Cantract Price $149 C,J�}/f9
.../�... � R1i11Crc»1k-NaWmd Oak . .... ... . ...... . . D£(?QSi!RBf}Uit'BG 4d! �io .D 59$4. ��. �O • 1
y: C}#�¢�,1C}4iil.PF1fC; ,��,.
� i futfy uncic+rstan�t�nci se;cexPt t1�e t�ansferabie warranty providecl.which cov�rs oaaly the p�;�pon Ins�tlauon ;y 8961.$U ����,�
1 areas of ttieUasemeni address�d and does no!a�ver watqr dama�€:.PartNal�enmetet �
� systems carry a iimiied wamnty .",umP�umps are cav�red by a aeparatc manulaciurer
wananty Instailhttot}o(41m sysi�m dc�s nat inGude pamling,fi��sh�ed carpentry,extendnp r�fuSt�r%mre�ar syau,m wim rrau rnvrerm�. x
discharge lino5.elactncai wcxk,ar ropiacc3nc�nt a(floc7r L4e,or c;arpeting C:antraatnr raitnc�2 �'�'^������r'"��'i�an-�t was�xir.rxivrusnesed :
� bct rESpvnsibla tor ftUzen dlsc.h�rgc�IineS without an Ir.�Guar[1,c;onq[7nsr�Uon,c#amp spat Hnmecawner�s»wa�e v!v>rvrc� X� ��r�'j �
disc:oior�tmn,water rance piEmip�d frcim house,winefow wc;li ffooding,or fuet ianks or unes �++�«tenanco�yrarr,
� Customa.,shall grant cc3ntractor�8�day tigint to remedy�ny prob�em afier rep�oriod. p �ya,���,.,;��i,�� �; �
Nameawn�r responsibl�s tor movirt�ob�octs aivay fram walls and�ack aga[rr_Some dust
� shl��ld be axpedad frr�m vrork.Pa��monts ta be madcs irt tull upon compVetiort.Atf m�tenr�l� A Radcur aystem was reccornrte�c9ed X �
� �uaranteed to tae as specified_lU!wofk 1n Ge crarr�p{etr-rd ar:cvrding to SPte stdr�cS�M �
pndic�s.Any atteraliarr from atwve spec�fiicattans wlll be c3xecutacf Qnl;upon tivnlien TypR�,,��{y; ` ��� ���
asders,and wili bee�n7u an oxt��r cFurrgf, All agr�c+ments continc�ent u�t�n�cc:ie7�nt;,ur
� � Ex�GngwaSlBnlsh: Piam ��
deieys beyond our cantrol Our workF�rs are fully cx�vetect t�y workman'a Carrrpt!nsation
insurance.NomGowner assumes a!k renpcinsidiffTy(or t#arrxr�cttzs;��i4 Tt�praekaqe c�t any F�nnag twor t�n2ah: �'
hid�en fuet;utilily service iines.SYor�uc,�h wci wiii t�o our tiast t�avofd such damage-AI! � .� ���
propas2ls l��sed przn�arfty oz�rrc��n�� descrlplion of problem Wamanty daes n+at ptav�rr ��hp�����"�1°^�'�y N°�^�"� � `"
w�t�r dam<�c}e.'This presposal y p �iil�dr��wrh Dy us�i)ttpt ace;�ptt�tl w's?hin 1;LU d�ys. qpproximate wsU sqft.: ti �
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s.abstactary ancl atcr herrat r� kercl frxi src autharrzrt�i tn d�thr work as spet:ifretl PaYment wrii bv �j�'E �1'�`r��''�+3��� ��*����
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RE��E��� �'�� ���� ��!���.l���E
PLAN CHECKED BY DATE ��- �� -�
----�..�__ _ _ _
Compie#e Basement S , � .. .:.
�,, Ryan Brer�ner
Yaur 8asement l�rt�lessronal ��
www.MyGampist+9ace�nent.com �� �,
(800)fi38-5285(612j 9t6-1187 �
54064 Ltren Dr,
��l�°���. '� �
MankaW.MN 5&001 ��
FAX (S07}62b-3�43
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�� PROPOSnL�A7E� 07A9l2Qt, Ef`iAlL: dMr4�iinb�srgh.cam
� SUBMITTED T4 Dave Berg �IbSE: 812-.2bT-i577
ADUi�55 � 38&9 N4Alrshare dr Wayuta IYH+I 55391 —
,K?H t,OCA7tUN: 366�9 Morthshafe dr Wayiata IAN 55991 CF,:t.L —
FAX —
System Faatuees
C�eartSpa� t740 . LBwn5cave 0utht _ t = APPRQX.INSTh1.lATIOM DATE:
S�,m,g Energy : SmanDram AK'PR�X.COMPIETtON DATE�
.... ... . .._.. .__ __. �.uurawar.w.rn..rsv:
Ufli�tate Enat�y ... ...... . ... . �RemC}iulet . .__.. _.... ..._.._.. . . ._.. ._....
.._._.. ,.. ,....... ..... . .._... ......... .... .
Wrap Piars t < RairtCtw�EZ
CI�n8��ece Dtainage t0A2. LawnSaePe E#. _ .
C1ean5{sace Varrl Cov�rs 2 � SmartJack _ _
Everl.as7 Dovr SarvDry CX Ai�Syaiem
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�EverLast A60ea9 Wbtl � :SaruQry UprigM �� � ��•.
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TFx3 Ttirri. -.... .... C:rawl-Ck5pfic+w ... . �.
r1t '�i`�i'-� ��k�
WapCap SmaA Jack HeatlertLF) , . �'�I.�ay,t ;i��y ' , 4
Te�raBk�cic . . . . Pemnl. . . . i . �'"
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SilverGfo ... . . . .. . Spray Foam T($F) _ . , .. ���� ry - ;�`�`� ^ � �����
..... ,... . . .. . _. . . ... _. . ....... ._ `.;� .�. ��y �, «
SmarlPiVe T7Krmax(SF)
Detxts Remavnt _ _ Sarria F�i �_. . '...:: ..;
Regratie fbt 6ramepe Santx Fe Epte
iSmeRSur� . . .. ... . . . �..SaMa Fe Ed{�ti. . .
p ..:TnpksSata � t . �� ,Wnixx Rate .. . ... . ,t ...
�:..Suo�urr�...... ... .. .. .WG and[harn t�. ._.._ ......•�62 . oFrKa,go aewwwawtiAc�lEn ..
UtaaSueYy _ _ WG'Pf0(?O$8 _ ...
.���� � . .. .. .,2 �. ... .7a iavet�rtlaoeiW d 19ppr-�mAy�lela m acm+dwm wM a0mc �.
�s.aracai�cn�ona,kx�awn M
{tvily understarxi�nd ac�ept tha trenstersbFe warranry provided.artuch covers oniy the
ateas of thebasement addre�sed and does not covnr water damage.Partla{perimoier (��g@m@tI{Q�@ $ �.QQ
�yslems carry e limited warranty.Sump pumps are c:overed by a separ�te m�nufacturer M}+��BV�SPB�PfipE $ 14�$1.80
warramty.InstaUatiori ot ihe syslsm does not irtdu�patnting,finished t�.trpsnlry,extendirg
discharge lines.e�ctrice�work,or r�slece�rot of t�or tiie or caryetine.Gontraetor�rmot TpfBI CO�ttiACY P`T1C�g $�I���,� V"
be responeible tor frozen discharges tirnes wilhcwt an IceGuard,mndenselion,damp spat ��� ,,� a� $ �M
disaoloratian,water au;e pumpeel frqn frouse.a�dow well Oooding,or hrei leAks or ltrtes. p� $ 8gpp.80
Custamer shail gram contractor e 60 day right to remetly any pmblsm 8fter reported.
FioRteow�r respo�stG�for moving+�jeds ew�y fmm watis and back�gain.Snme dust ����I�s�� ; �1,�
ahoufd he expeded from wortc.P�yrt�rtis to Ge mada ir.tup upon Campletion.All materisi is _. _._
gLL8t8nt88d to b@ 85 SpCCIfl�(1..All WpFic(O b{I t.'tlfff�'l!@tEKi BCCtlfYlltlg to ihB S�S�1dHld A t�l s
areaioes.Any aueretiar,from atrave u�wiu be exea,►ed °��'a�e` '�em,Km'a�w�+�. x...__.._ _.
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a11y upon wrfiten sealed af 1ba�7wn�pkrt was recarmsentletl
o�ders,et�d wiil betxsnte en erXira Gt�rge.All agraettients caMingent upor�aoCtde�ris�xr Nameauner is aware W X
dBi8p5 � �OUi GiNtiral.OUt wOtk$r5�8 hJlly CO�tEd tTy WOtk(118ti°3�C:O!'TSP�n�tiOtf main�Fla��ce txOQfArt7 .. .
insure�e.Fiomeowner essumes afl responsibility for dsmsges due to bresakage of any A���e �
Mdden fueUutihty service 6nes.ttwugri vr�ar�f do nur be�t�ew+d sut�damage.All
proposeis baaed prm�riiy an twmeownats descnptfat af problem.Wamenty does rat cover A Rador+ � �dmd x
water damege.Th�s d ms�y be a9thdr�swn by us if troi ac�pied arth�n 120 deys,
Type of+� 9�x`-t>P§r'�
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3ailer`s Sigr►aRtre � Ez�su�Q waH fi�h: i��rr
Exbtlng�flnYsh:
�. �r�af�Prc�oswl-it��»Ccwa�nrns.Fy�rifrcalmns,oontliiwns mui seParate wananty are...
�uf a� .Yau are auBwnzetl to ao the wmr4c aa apedRetl.Payment wip be � �. � �+Y k�a+#ww�sa: �
mvde as ouFin�d abdve.� ON � tTEM �IUS IO IN FULL ANU ARE NOiV EfU DAHLG�.
e�yerB `� e' .� �,�,! 1�- �"°x�..v�,�tc.: o
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Buyer's Signature: I)ate �
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� ro��or.r.Tiow 36fi8 Nort#►shote dr i�ayzata,MN 55391
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� A:Fumace hung from�qing
� B:Lawnscape b�ket in bushes
� C:Wrep inferior wgN with Cfea�space �
� p:Drop down antry N�rough clo�l. �
� $PECI�IGATtO1VS. �
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1.Insiau TripieSa€e pump sysiem with twin iiner,1t3 hp r.a►st Imn pnm�ry AC�aump,tt�hp cast�ron AG back-up pump,and UttraSurnp batlery �
back•up pumpi�g system with oharginglcantrol box with alasm,and'12�amp sealed maintenance iree Uattery.includes 3 CleanPump stands,airtight
�txt writh airtlght fioor dra�n.and WaterWatch aiarm system. Z.Instali lceGuard to prevent f�oods hom frozen discharge Ime. 3.Instaii LaNrn3cape
cwtiet el end of discharge trne�. 4.Install vent cav�tss over vents. 5.Install GleanSpace trawl space encapsufat�n system in area shown. 6.InstaH �
�CleanSpace Drei�ags Matting und�r Clean5�tiner. fi.Vtirap it�bottom ot plers. $_Permtl as needed, 9. �. 14. �
Waterguarti and drain tiie 17.Instc+ll extra lawnsca�as shs�rvn. _ p
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PAGE 3 OF 7
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CLIEN7: BASEIIAENT SYSTEMS, INC. W
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Test Repart 11fo: 9 G8829 Date: • July 12. 2002 m
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SAMPLE ID: The Clie�t submitted and identified the following tes# material;as Cleanspace W
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DA►TE OF REC�lP'f: Entered inta SGS USTC sample tracking systern on Mey 29, 2002 as STN �
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T�STING P�RIt1D: July 3, 2002. �
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ALJTHORtZATlON: CEient's Purchase Ortfer Na,.12400�. o
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TEST.REQUESTEA: Perform standard flame spread and smoke �ansity deveioped dassification tests on �,
the sample supplied by fhe CC►ent in a�xvrdance with ASTM Designation E84-01, N
• "Standard Niethod of Test for Sutface Bumin��Ch�,cac�eristtas_afi�Bcu�iding Materials". p
� , � The foregoing test procedure is camparable LtG.=Ui�7�3,�ANSIINFPA No. 2�5, and �
� UBC No. 8-1. • �
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� TEST RESULTS; ,��ttt@ SPrea[3 Smake Densitv o
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Test Techniciari , .. _... �. . �� , �~��u.x:r �, - , -Superv.iss��;F�re�•Technab.gy .. � � �,
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This repoR ie isaued by 5G5 U:S. Testing Compwny inc. under!ts Gehetal'Condftione fnr Testing Senrices icopY eveilabEe uPon roquast}. SGS �
U.S. TestinQ's reeponsibdhy under thic �eport is fimited to proven naqiiyence and vrill in no case be rnofe then tha amount af the twsting feas, $
�xaept by apecis!arrangemont,sarst{Slas ara not retainad by SG5 t1.5,Teatina for rnore than 30 days. Tha rosuib ahown on this teat raport rofer �,
only to tho sample(s) testad unfees otharwise statad, undmr the conditions egreed upon. Anyvne relyinp on this rapart ahould undorstend al� of e
the details of tha engagement Neitt►erthe neme, seals, merks not insipnia of 5GS U.S.Testing maY be usad'm eny advarsising or p�notior�al o
msterials without tha priar wtitten approvet of SG5 U.S. Tesrirtg. The tast rapoR cartnot be reproduasd, except in fuit, wi'thuut p�ior wtittsn �
permission of SGfi U.S.7esting Carrtparsy Inc. ' � �
M1/jem6er cf tSia SGS GreuQ lScc9btg(ii++b�sle de Suroeilfanoe) o
SGS�SGS•SGS�SGS.SGS.SGS�SG6.SGS�SGS�SG5�6RS�SGFrStiS�Sfi9�56'S�.:GS�585�6�a$'B�aSM''��8"B�Sa�a�'sas'608�563�5GS�SG�668�SGS+S[t6•SGS•St35�SCss."'
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� PREPARAT{ON AND CONDiTiONING: The sarnpie material was submittsd in one piece 24" wide by 24' s
' long. The sample was supported during testing by Z" hexaganal mesh poultry netting running the Q
; lsngth af the test chamber and '/a"raund matal rods placed at two foot intervals across the width of the n
'' test chamber. W
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' Prior to tes�ing, the specimen was placed in the.candt�ia�ring. coom:(rn•airrtairred at 73.4 � 5° F anzi a �
� relative hurnidity af 50 �-5%y and aliawed to reach maisture equilibrium. „
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� SUMMARY O� ASTM E84 RESULTS: 6ecause of the possibEe varistions in repr�ducibility, #he resufts �
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: Crawl Space Liner o
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� in arder to obtain the Flame Spread Classification, the abovs results should be compere8 to t e �
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� NFPA GLASS UBC CLASS � FLAME SPREAD o
� p+ � 0 thr�ugh 25 r
� g I! 28 t�rough 75 p
� C (�� 76 tt�rough 200 �
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N BUIL,DING CC1DE� GE`CED: ' ' � � � �
° 'f . Nationa! Fire Protec-tion Asso�iation, ANSIlNFPA No. 'f 01, "Life Safety Code", 1994 Eciition. °
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� 2. Uniforrn Building Code, 1994 Edition, Chapter 8, Intarior Fin�shes, Sections 80'l-807. y
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SGS�SGS�SQSrg({S•SGS.SC3S•6GS�5Yi$+SOS.SQS•SGS•545.BBS�St9�8t38`S@9�SCsS�56S�5Gfi��St�5�365.�65�SG3.5G3�3f39�SSCiS�SGS•SGS�365�809rSOS�SO^rSO5�8G9'SOS'6Ci5'SGS�°1
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Date: .fuly 12. 20t32 ;
CLlENT: BASEMENT SY57E�tlS, lNC. Page: 3 of 4 �
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E 84 TES'f DATA Sl-IEET: • ti
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CL1�NT: Basement Svstems, Inc. DATE: 17 3/02 ' y
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SAMPL�: Cieans ap ce �r�wJ Space Liner. � �
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FL4ME SPREA�: n
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IGNI'i'10N: 24 secands m
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FLAME �RONT: 2 feet maximum �
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TlME TO MAXIMUM SPREAD; 1 minute. 20 seconds �
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TEST DURATION: 1 O minutes � m
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CALCULATION: 18.30 X 0.515 = 9.42 ' n
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SUMMahRY: F1AME SPREAD: 10 SMOKE DENSITY: 10� �
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OBSERVATI011tS: Sarnpfe surface ignition occurred at 24 seconds. A maximum �flame front advance of �,
2 feet was observed at 1 min�rte, 20 secflnds, Flaming dri�s and fioor burning were noted. ;
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CLIENT: SASEMENT SYSTEMS, 1NC. Page: 4 af 4 „
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AT TIME �
CITY OF ORONO CALLED IN / / �. ,�,��
INSPECTION NOTI SCHEDULED / i •��c._.
PERMIT NO � �� COMPLEfED
ADDRESS �' ���- �r� `�
OWNER T EPHONE '3 7
CONTRACTO S �
� DESCRIPTION
�
� 0 FOOTING ❑ PLUMBING FINAL p EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y O FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� �FINAL 0 SEWER HOOK-UP ❑ COMPLAINT
v�❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
� 0 DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v O PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS: �!�• �'�^L •
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� s/i/G�l�s • (JI� COIGeTi�cc�1 � �
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� �lt /,D/O!i� 1��0✓ Snra� �i��t..�Q S.O/'� ��
a �`G �tsil S��e '' yrl�rxbr��te � a �oow e r
W� ❑WORK SATISFACT RY:PROCEED fa S 4�/O �I�ROJ ECT COM ETE
W ❑CORRECT WORK b PROCEED /Of'rK�p � -f�,s ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION �� - TEMPORARY
V BEFORECOWERING f�l��C�W�Q/ � �p/�ty�Q�ANENT
❑CORRECTUNSAFECONOITIONWITHIN HOU S.. p PHOTOTAKEN
INSPECTOR WILL RETURN �/C�r� � •
�STOP ORDER POSTED.CALL INSPECTOR �nJ�t�YCITATION I UED� �-���
��w�✓ ..r C!a � ��cL /�
�INSPECTION REQUIRED.CALLTOARRANG ACCESS. n Q���t �����
��n.c�`+ -��t3 -$2��j - �..
C t inspection 24 hours in advance. (952) 249-4600
site C�
Inspector:
ite Copyllnspecto�'s File Canary CopylSke Notke