HomeMy WebLinkAbout2016-01030 - new structure .�'J``r �
CITY OF ORONO * 2 0 1 6 - 0 1 0 3 0 *
2750 KELLEY PARKWAY DATE ISSUED: 09/26/2016
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 495 NORTH ARM DR
PIN : 06-117-23-31-0014
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 21 BLOCK 3
PERMIT TYPE : NEW STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SINGLE FAMILY
ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED
VALUATION : $ 700,000.00
NOTE: SEPTIC AREA:
SEPERATE PREMITS REQUIRED:PLUMBING,MECHANICAL,FIREPLACE,SEPTIC,WELL&ELECTRICAL
NOTE:SEE BUILDERS ACKNOWLEGEMENT FORM,READ AND INITIAL
APPLICANT PERMIT FEE SCHEDULE 4,679.92
NORTON HOMES STATE SURCHARGE(VALUATION) 350.00
18215 45TH AVE N,STE D TOTAL 5,029.92
PLYMOUTH,MN 55446- Payment(s)
(612)386-7661 CHECK 1810 5,029.92
Minnesota State License#:BUIL-BC639221
OW1�1ER
Norton Homes
NORTON,CHRIS
18215 45TH AVE N
STE D
PLYMOUTH,MN 55446-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
[he 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 l80 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at an t'me for due cause.
_ � L l� � �Z�� l�o
Applicant Permitee Signature Date Issued B gnature Date
' , . r
. � CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�O� MailingAddress: Permitnumber: � -D/030
PO Box 66
O Crystal Bay, MN 55323-0066 Date received: �`"
_ ___._._..._�_ Received by: ,.�
StreetAddress:' r- f� `4!
yF G� 2750 Kelley Par ay �� �� Plan review fee: L
�y �, Orono, MN 55 6 �'r� %�� _�_
KES H�� Mai n: 952-249-4600
Fax: 952-249-4616 www.ci.orono.mn.us � � �v�� � �
This application form must be completed in fuil and all required information must be submitted. �
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: ��9� �UC��, r�'}� �r�V�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o
If yes, a special event permif is required with Police Department and City Council approva160 days prior to the event. Shuitle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APP,4ICANT INFORMATION:
Name: Nor�vr-� N���e S, L � �
State License# BC [�3S}�--I Expiration Date: 3—,31 - / 7
Phone: cell) / }- 3$(0, � office ?G . S$�- 9/
Mailing Address: /�a-/ �+- , /J Cit : rn,t/ � S,5"yy
Contact Person: ri Or Applicant is: Contractor / omeowner (Circle One)
Email and/or Fax: G r� ,/'1 C4ih..
PROPERTY OWNER INFORMATION:
Name: �(�t S N C1r'-,—dv�.
Phone (day): (o��- - 3�(,- 7 S�L �
Address: /'�:t-/5 y�r� /�,�z �/ Cit : ,. L, ZIP: — �
Email and/or Fax C 1'iSivc2�/lu%-��-���µf3 , Co ��z
ARCHITECT I ENGINEER INFORMATION:
Name: �f' P �1CLrYY1�'r1u � �S i�i n
Phone (day): �(�3•'7 • r60UY �� Q
Address: 9/du 8a-�r�%n�n-e Sf , /�/F S�- /O� City: U�Q.�r�-� ZIP: SSYY�J
Email and/or Fax: �
PROJECT INFORMATION: Description of project: � t,l.��
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal &
Water Supply
� ew Construction ❑ Single Family with ❑Accessory Bldg./Garage
❑Addition attached garage ❑ Deck ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage ❑ Residence ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
**Any earth movement may also require ❑ Commercial ❑ Storage
MCWD review& permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(SpeCify)
15320 Minnetonka Blvd
Minnetonka, MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ �UD DDD
—�
Last Updated: January 2016
STRUCTURE INFORMATION:
1. Structure Dimensions 1. Structure Dimensions(continued)
a. Length (ft.)= ?�`1� Number of bedrooms= y 2. Occupancy:
b.Width (ft.)= j/� � Number of garage stalls:
3. Occupant Load:
Areas in square feet Attached =_�
c. Basement= 2�-�/`� Detached = 4. Type of Construction: �L�� �
d. 1 St story = .�y 3�—
e. 2"d Story= 5. Code Edition:
f. '/z Story =
g. Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed Applicable
❑ ❑ Buildin Permit Escrow A reement and Fees
❑ ❑ Plan Review Fee
❑ ❑ Completed Ap lication Form
❑ ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/z x 11 set
❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
❑ ❑ Survey—2 full size, to scale(meeting ALL survey requirements)
❑ ❑ Hardcover Calculations
❑ ❑ Septic 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.
Applicant's Signature: �� ��� Date: �"o� �•� ��.
/� �
Owner's Signature: ( � !� Date:
Last Updated: January 2016
Builder Acknowledgement Form
Permit #2016-01030 / 4 5 orth Arm Drive
Builder Representative Name:
�� �_
Permit Conditions: Initials
**NOTE CHANGE** Before scheduling an exterior insulation and/or drain tile inspection,a
foundation as-built survey must be submitted and approved by the City or a Stop Work order
will be issued. ��
Schedule a minimum of one hour for the framing inspection.
��
Erosion control mechanisms must be installed and inspected by the City prior to any land
disturbing activities. The contractor must provide a minimum of a 24 hour notice prior to /
inspection. �t tv
Erosion control shall be installed and maintained throughout the entire project and must
remain until vegetation has been established. �dl/
A haul route shall be submitted to the City Engineer for approval and inspection prior to
commencement of hauling from the site.The property owner shall be responsible for cleaning
and repair of roadways for any adverse impacts.
No underground sewer within 20 feet of well. 0
�
A separate permit is required to be submitted and approved prior to construction of the pool. �
Prior to the issuance of a Certificate of Occupancy an as-built survey must be submitted and � . /
approved. L �t�
In the event of winter or other extended unfavorable weather conditions(which prevent the
completion of the exterior improvements and/or as-built survey)a Temporary Certificate of
Occupancy(TCO) may be necessary. A TCO requires a $10,000 escrow. G�
Advisory Comments
Any changes to the exterior/landscaping improvements, i.e. patios,grading, sidewalks, retaining
walls,etc. not currently shown on the approved survey and landscaping plan will require a
separate Zoning Permit application to be submitted and approved prior to the work
commencing. o�''�
Any retaining walls that are over 4-feet in height or tiered walls not separated by twice of the
height of the lower wall require engineered plans and a building permit to be submitted and
approved prior to construction. �
w:\street files\north arm dr\495\builder acknowledgement form 2016-01030.docx
� ' PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: - L"1� Nl ]I 1-�t r V � �• Permit No.: ��� � Q l�c�
Description of work: _� ���/ Date Rec'd: �'1-c5'l �j
Septic review by: ' Date Approved: � �q �O
Zoning review by: ' Date Approved: •ZI ' �
Building review by: � �� � .�%�' � Date Approved: l
Grading review by: C,Z/ Date Approved: ��-�L�
Zoning District: � ' Zoning File#: Reso#: Reso Date:
Zoning: Lot Area:� L5 F AC Width: Lot Coverage: �' SF �� %
Survey Submitted: �s � No Date of Survey: $'L4"`�V/ Revised date(?): ����1'��P
Landscape plan submitted? �Yes 0 No Landscaper: _�Y��,��
Proposed Setbacks:
n� � �J'b 30 �p'
Front ( ej Rear(S et� � S E W ) ( N E W ) Other Buildings -lRVetaa�d-
� Side �de ,�� , �}
t . . �
ho �ema
� �j-1 � � Z-j�
1
Defined Height: Peak Height: FE: minus 6 - ' g Contour;
Perimeter(lin = ° - . . below gra
asement? es Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
I The distance between the iowest proposed Slab at or above grade-
� - space�and measure from hi hest existin
� _ (1�(n CI� START WITH ra ade to the highest point the
(�f�.- ����S� �S roof even if fill was bro t in to
_
v'"M ' ��� (1!n Q� elevate home.
�� "�yG 0
� ,o Slab below ade-measure
�'�--� istance from high existing grade to the
/L he roof hi hes oint of the roof.
�T onding If y have a...
SUBTRACTION ' GABLE OR HIPPED ROOF
N�th (BASED ON (no windows): Subtract half
istance ROOF TYPE) the distance between the
���'�� /'�.��I � ��G I t highest point of the roof to
r T(/ l'� ( �� ct the the low point of the
� 1 �-� � �—� n � corresponding gable or
�j hipped roof
I� ' iat. • GABLE OR HIPPED ROOF
_ _ (with windows): Subtract
half the distance between
the top of the highest
�E window and the highest
;less). point of the roof
�� I ► - • ALL OTHER ROOF TYPES
� � ���_�,� (flat,mansard,etc):No
subtraction.
Z� � / Defined building height
� EQUALS
Updated: May 2016
z:\forms\plan review checklist 5-2016.docx
Shoreland District MCWD Permit Average Lakeshore Setback g�uff
Met?
Permit Number: �(n —4�� � Yes � No �A � Ye No
Yes ❑ No �r
� N/A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and sf
� �L��q�,l� � Yes o 0 Yes No
1 2 /' 3 ) 4 5 ./� a Type(s): Type(s):
�� � 3,��4s i-
Fees to be Char ed YES NO
Permit
Plan Review '
State Surcharge (�
Investigation Fee �
SAC—Number of SAC Units - � ��
Other(specify)
Square Footage $ per Square Foota e
Basement X = $
1 S' Floor X = $
2nd Floo� X = $
Garage X = $
'``'C' �'C�C�
Estimated Construction Value: $ / �,
Orono Inspections Required Work Requiring Separate Permits
�Footing 0 Site � Plumbing +. � Grading/Filling
Poured Wall Silt Fence/Erosion Control Mechanical � Fire
�,Foundation Survey � Hardcover Removal �Fireplace 0 Water Connection
0 Framing 0 Other(specify) � Masonry 0 Sewer Connection
�Waterproofing/Drain tile �Mfg. 0 Lawn Irrigation
� Foundation Waterproofing � Other(specify) 0 Landscaping
Framing
Insulation
�As-Built Survey
�Final
�Z4 Lathe Required State Permits
0 Other(specify)
Well Electrical
REMARKS (in-house):
OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED:
See Builder Acknowledgement Form
� rior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
Updated: May 2016
z:\forms\plan review checklist 5-2016.docx
Permit Application: Self-Checklist for Completeness
Please note, the applicant must initial in the boxes below to acknowledge the minimum required
information is included with the submittal. If not, the application will NOT be accepted. Call
952.249.4620 to schedule a meeting with staff if you have questions on application submittal
requirements.
�
� Completed Application ��
��
t���
Plan Review Fee Paid �
I ��
� G����"� p�-(
�;(,.� � f '�l � � � �
�� � �"
�;� Signed Escrow Agreement & Escrow Payment
Building Plans (to scale) x2 ' 6-�
�
Certificate of Survey (to scale) showing the proposed project & ��
meeting all requirements x2
Hardcover Calculations (if applicable) �/�a�-�
�
S �
� �
I am aware that Orono will not issue a building permit without a -FI�e
copy of MCWD permits (or documentation from the MCWD stating
the proposed project does not trigger their permitting
requirements). I will contact the MCWD at 952-471-0590
regarding this project.
Signed by: ��'��
Address: �'1� �fi�r1��'�� �.�'w` ,�i? G'��'o i10 -
Permit #: 2, p / (�., _�/ p�a
Last Updated.� January 2016
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City a�t t�rano f'.,;'� 2 5 2016
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2.�!(� • 0�030
`l+ �-�rdcw't.f''
C:�c�u�.�oc �ar�
. , RECE�VED
New Construction Energy Code Compliance Certificate AUG 25 2016
Pe�'R401.3 Certificate.A building certificate shall be posted on or in the electrical distribution Date CertifiCate Pos
panel. PI
Mailing Address of the Dwelling or Dwelling Unit City (�'y" ���R�Iv�
495 North Arm Drive Orono
r here
Name of Residential Contractor MN License Number
Norton Homes
THERMAL ENVELOPE RADON CONTROL SYSTEM
Type:Check All That Apply Passive(No Fan)
��O ���� o � orothersystemmonitoring
�� N �
11I w N
� �, N Location(or future location)of Fan:
a �
� U C � � a N
O O_ 0 "N' U p) p -p �
d n � � (� � N 7
� Q m m N C � 7 >.
� � y N � �- ll O
Insulation Location � ° Z � '_° U O m w N
ca `o m a' � E -o -o
�
m � � a� d � � � . .
� � z i�-i ii� �i ii � � � Other Please Describe Here
Below Entire Slab
Foundation Wall —/D �7 '� �.u�,.5(, � S c c
Perimeter of Slab on Grade
Rim Joist(1st Floor) �-'�,\
Rim Joist(2nd Floor+) —�.1
Wall -�
Ceiling,flat rGj
Ceiling,vaulted _ �
Bay Windows or cantilevered areas - d
Floors over unconditioned area jj y+ �Iv w
Describe other insulated areas
Building envelope air tightness: Duct system air tightness:
Windows&Doors Heating or Cooling Ducts Outside Conditioned Spaces
Average U-Factor(excludes skylights and one door)U: Not applicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): R-value
MECHANICAL SYSTEMS Make-up Air Se/ect a Type
Domestic Water
Appliances Heating System Heater Cooling System Not required per mech.code
Fuel Type Natural Gas (�`-}r..L Electric Passive
Manufacturer Lennox J�d, S 1�,,�l� Lennox Powered
EL296UH090VX48C- XC16-048 Interlocked with exhaust device.
Model EL296UH070XV366 XC14-030 Describe:
Input in 88K/66K capaciry in Output 4T/2.5T Other,describe:
BTUS: Gallons: in Tons:
Rating or Size �,
AFUE or gg SEER 16/12-13 Location of duct or system:
E�ciency HSPF% iEER
Heating Loss Heating Gain Cooling Load
Residential Load Calculati 90,115 65,115 5.4 TONS
Cfm's
"round duct OR
MECHANICAL VENTILATION SYSTEM "metal duct
Describe any additional or combined heating or cooling systems if installed:(e.g.two furnaces or air Combustion Air Se/ect a Type
source heat pump with gas back-up furnace): x Not required per mech.code
Select Type Passive
Heat Recover Ventilator(HR� Capacity in cfms: Low: 105 High: 210 Other,describe:
Energy Recover Ventilator(ER�Capacity in cfms: Low: High: Location of duct or system:
Balanced Ventilation capacity in cfms:
Location of fan(s),describe: IN HRV AND BATH ROOMS Cfm's
Capacity continuous ventilation rate in cfms: "round duct OR
Total ventilation(intermittent+continuous)rate in cfms: 605 "metal duct
Builders Associaton of Minnesota version 101014
' Ven��it��ion, Makeup and Combustion Air Calcufafions �
� � Submittal Form For New Dwellings
These blank subm(ttal forms and instruct)ons are availabie at the Ctcy of Chaniiassen webs(te and at City Hall. The completed form must be submlt-
ted 1n dupiicate at the tlme of application of a mechanical permit for new constructlon. Additional forms may be downloaded and printed at:
http://www.d•chanhossen.mn.us/serv/bulld.html. •
Siteaddress ) � � Qr�i '
�—i h y tV, Date � 1a�i( �
Cootrector �ed � I Compieted I
,c� B �', i
Section A •
Ventilation Quantity ,
(Determine quantity by usingTable N2104.2 or EquaUon il-]) '
Squarefeet(Condidoned areaincludi�g . I
Basement—finahed or unBnished � �,� �
1 7otal required ventilation �
Numberof bedrvoms Continuousventilation ��� �
Directlons-Determ/ne the total and continuous t�enfilation rate by either using Tab/e N2104,2 or equation 11-1. ' i
1"he[able and equorion are below. �
7abie N1104.2 •
Total and Continuous Ventilatton Rates(in cfm) • I
� Number of Bedrooms • . (
1 Z . }
3 4 � 5 6
Conditioned space(in Total/. Totai/ Total/ Total/ Total/ 7otaf/
sq,ft.) continuous continuous continuous continuous continuous continuous
1000-1500 .60/40 75/40 90/4S 105/53 120/b0 135/68
1501-2000 70/40 85/43 100/50 115/58 �,30/65 145/73
2001-2500 80/40 9S/48 1�0/S5 125/63 140/70 i55/7g �
2501-3000 90/45 305/53 , 120/60 135/68 I50%75 165/83 �
3001-35Q0 100/50 115/58 130/6S 145/73 160/80 175/88 '
3501-4000 110/55 125/63 I40/7� 155/78 170/85 . 185/93 �
4001-4500 120/60 135/68 1S0/75 165/83. 180/90 195�98 �
4501-5000 130/65 145/73 160/80 175/88 190/95 205/103
5001-5500 z40/70 L55/78 170/85 J,85/93 200 100 ziS/108 j
5501-6000 150/75 16S/83. 280/90 195/98 210/1 225/113 �
Equation 11-1 ' . •
j
(0.02 x square feet of conditioned space)+(15 x(number of bedrooms+1}J=Totai ventifatlon rate(cfm) I
� Conditioned space includes the basement. "' � �
z If conditioaed space exceeds 6000 sq. ,ft._or there,are,more than 6 bedrooms, use I
' ' ' Eq'iration 11-1 from Section 1VI104.2 to calculate total ventilation rate. �
7otai ventilativn—The mechanical ventflation system shall provide sufficient outdoor afrto equal the total ventilation rate average, �
for each one-hour period according to the above table or equation. For heat recovery ventilators(HRV)and energy recovery ventila-
tors(ERV)the average hourly ventilation capacity must be determined in consideration of any reduction of exhaust or out outdoor
air intake,or both,for defrost or other equipment cycling.
Continuous ventilation-A minimum of 50 percent of the total ventilation rate,but not less than 40 cfm,shali be prov(ded,on a con-
tinuous rate average for each one-hour period. 7he portion of the mechanical ventllation system intended to be cont'snuous may
have automatic cycltng controls pravlding the average flow rate for each hour is met, •
Page 1 of 6
� !
' � • RECj..,,'a�ED
' �-�H� �o��- AUG ��'� 2016
�H VAC RESIDENTIAL LOAD CALCULATIONS CITY �� � Based
o�.,ro�. on ACCA Manual J8ae
LEARNiNG SOLUTIONS'
Mswctlon�s:F�+b►d�fa qieo fh� .M otlMr Aek�are hxt Ein J�fde�n eslcul�tfons.
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arM add Intemai Ma . ,
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Ne R�ureWl sh�d� Area
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A�N
u
E s W X Coolinp 8S 58 E5
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ap qlau and doeis bnu�Non b 0 0
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�w so.ro n�wo� o 0 0
rac wan�nnrw.oraa.r� �'�o x�o ■ x t+�.nnq � .a�.y. . 2�+.+0 : � aa :
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My ReMMO M�tsrial Coo11o0 2t.{2 i 7 1.60 1.97 0.98
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0 0 0 0
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_._ _....-_�.._ p a
� ���);y�� �od� RECEIYED
AUG 2 5 2016
�HVAC RESIDENTIAL LOAD CALCULATIONS Based u
LEARNING SOLUTION� on ACCA Manual S� OF ORONO
lnsbuetlons:E»hralata!Mo uow Ns/ab en .All oMer fl�an Gke flNds an dku/aebns.
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Sectlon B
Ventilati�n Method
(C1►oose either baldnced or exhaust onl ) �
Balanced,HRV SNeat Retovery Vendfatot)or ERV(Energy Recov- Exhaust only
ery VerttilatorJ—cfm of unit)n faw mu92 not exeeed continuaas venth CanUnuvus fan rattng in cfm
IaUon ratlngby more than 100f6. , .
�W�M� q 4 High cfm: ��� CdnNnuous fan nting in ctm(eepacity must not exceed
0 conUnuous ventllallon redn more than 1007C)
Ofrections-Choose the method of venrilatlon,balanced or exhaust only. 8a/anced vent!/aiion systems are typicalJy HRV or ERV's.
Enter the!ow und high cfm amounts. Low airflow must be equal to or greacer than rhe required�p ifnuous vent!lotton rpte and
/ess ihan T00%greeter than the contfnuous rate,ffor/nsfance,if ihe law cfm!s a0 cfm,the ventilation fnn mus[not exceed 80 cfrn.)
Aufamatfc contrals may n/low the use of a larqerfon that fs operated a percentage of each hour.
Sectian C � ,
Ventilation�ar�5chedule
Descri tiort l.ocation Continuous In�ermhtent
'�I, r� L . 1
Dlrecnons-The ventilatlon fan schedule should descrlbe what fhe fan is for,the/ocatlon,cfm,ond whetheric is used for continuous
orincermlttent ventllat/on. Fhe fon that fs chose forcontinuous vent!latlon mvst be equal ta orgreater than the/owcfm o�rroting
and less rhan 1009L greater than the contlnuous rate. (Forinstance,lf the!ow cfm fs qo cfm,the contlnuvus ventifatfon fan mustnot
exceed 80 cfm.)Arrtornatic controls may a/low the use af a larger fan that is opemted a percenxage o;each hour. I
i
Sedion 0 �
Ventilation Controls I
Descri6e a eretion and tontrot of the eontfnuous and internlletentventllaUon} �
S �, r N u i
!
�
. t
' Dlrections-Oescrlbe the operatlan ojthe venUlotion syscem. There should be odequate detailforplan reviewers o�d�nspecton to ver(�y deslqn pnd )
fnstollation compUu»ce. Related trades also need edequate deEoll for pincament of controls and proper operallon of the$ulldfng veatflatton. If �
exhaust fans ore rrsed jorbel/ding ventllation,describe dre operot/on and focatfon of any controls,Indicocars and/egends. ljan�RV orNRv!s to be �
installed,describe how lt w11lbe fnstalled.If k wlll be connected and Interfaced with the air hondling equlpme»�please describe such connections as
detalled In the rnanufactures'installat/on Instrucdons.!f the)nsta�lat/on lnstrucuons req�Ue or recommertd the equFpment to be interlocked with the !
air handlfng eqWpment jor p�oper operatton,such/nterconnectton shall be made and described. . �
Sectlon�
Make�up air
Passtve(determined from cakuf�Uons from Table 5013.1)
Dourered(determMed Ftom ealcu(atTons from Table 5�A.3.1)
Interlocked with exhaust device(determined irom alculation fram TableS03.8,1�
ather,deserlbe: ' ,
location of duct or systeri�ventflatton ritake-up air:�etetmined from make-up air openin@ table
�� 5ke and typa(round,r¢ctaogular,flex or r►gid} �
(NR meaos not requtred} � '
i
Page 2 of 8
i
. • ,
O/rectlons-!n order to determine the makeup aJr,Table 501.3.1 must be fllled ouc(see below). For most new Jnstallarlons,column A
wl/l be approprlote,however,if atmospherlcalty vented a�pp!/ances or so/id fue!appllances are instal/ed,use the appropriafe column.
For exlsting dwellings,see!MC 501.3.3. Please note,f the makeup alr quan�lty!s negailve,no addltlonal makeup a!r wlll be re-
quired for veniilatlo��f tfle va/ue/s poslrive refer ta 7able 501.3.Z and slze the opening. Trpnsfe�the tfm,slze of opening and type
(round,rectangular,f/ex or rlgid)!o the lasr Nne of sectlon D. The make-up a!r supply must be Installed per IMC 501.3.2.3.
Table 501.3.1
PROCEDURE 70 DETERMINE MAKEUP AIR QUANITY FOR EXHAUST EQUIPMENT IN DWELLINGS
Addltional combustion alr wlll be re ul�ed for combustbn a lances see KAIR method For wlculattoru
One w multiple power One or multlple fan- One atmosphericallyvent Muldple atmospherical-
vent or dlrect vent ap• auisted appliances and gas oroil appliance or lyvented gas or oil
ppances or no combus• power vent or direct veni one sd6d fuel appllance appllances or solid fuel
tlon appllances apptiances appilances
Column C Column D
Column A Column e
1.
a�pressure factor 0.15 0.09 0.06 0.03
cfm
b)condittonad floor area(sfl(including )a
unflNshed basements �� �'�!
Estirtwted House Inflltratlon(cfm):(la
x 1b ��
2.Euhaust Capadry
a)continuous exhaust-only ventlladon
system(cfm);(not spplleable to ba- �
lancad vendladon systems such as
HRV
b)clothes dryer(cfm) 135 135 135 135
c)80%of largest efchaust rating(dm);
Kriehen frood typically /,� �(�
(not applkable If redreulating system "/
or if povrered makeup elr is electrically
fnteHocked and match to exhaust
d)80%of next la�gest exh2ust rating
(cfm); bath fan typkaUy Not
(not appiicable if recirculating system Applfcable �
or If powered makeup atr is electrlcally
interlodced and matehed to exhaust �
Total Exheust Capaciry(dm}; /"�� !
2a+2b+2c+2 d �
3.Makeup Air Quant(ty(dm) �
a)total exhaust apacity lfrom above) �, r
b)estimated house Inflltratlo�(from
eo�e, . 6
Makeup Atr QueMity(cfm); /
�3a-3b) � Z�(�..b "
(If value!s ne8ative,no makeup alr Is �
needed
4.for makeup Alr•Opening Sizing,refer
!o Table 501.4.2
A. tJse this column if there are other than fan-essisted or atmospherically vented gas or oil appllance or if there are ra combustlon appllantes.(Power vent ,
and direct vent appliances may be used.)
B. Use thk column if there Is one fanassisted appllance pervenUng system.(Appllances other than atmospherkallyvented appllances may also ba In-
tluded.)
C. Use this mlumn if the►e k one atmospherkally vented(othar than fan-dsskted)gas or o8 appAance per veMing system or one solid fuel appliance.
D. Use thls cotumn If there are multiple atmospherlcally vented gas or oil appliances using a common vent or If there are atmospheMcallyvented gas or oil
appllances and soAd tuel applienees.
,
�
�
Page 3 of 6
; , � .
Makeup Air Opening 7'able for New and Existing�welling I
7abfe 501,3.2 �
One ot multiple power One or multiple fan- One atmospherically Multiple aGnospherlcally �
vent,dtrect vent ap• assisted appltances and • vented gas or oil ap- vented gas or oil ap� Duct di• �
plfances,or no combus- power vent or direct pliance or one solid fuel pliances or solid fuel ameter
i
Uon apppances vent appliances appllance appliances �
Column A Column e Column C Column D ;
�assiveopening 1-36 1-22 1-15 3-9 3 �
Pauiveopening 37-66 23-41 16-28 30-17 4 �
Passiveopening 67-109 42�66 29-46 ig-.2g 5
Passlveopening 310-163 67-100 47-69 29-42 6
Passlveo enl x64-232 101--143 70-99 43-63 7
Passlve enin 233-317 144-195 100-135 62-83 8
Passiveopening 318-419 196-258 136-179 84-110 9
w motorized dam er
Passiveopening 420-539 Z59-332 180-230 ixi-142 l0
w/motwi:ed dam er �
Paufveopening 540-679 333-419 231-290 143-179 11
w motorized dam er
Powered makeu air >679 >41g >Z9p �l�g �
Notes:
A• M equivalent length of 100 feet of round smooth metal duct Is auumed.Subtract 40 feet far the exteAor hood and ten feet for each 94 dQgree elbow to
detertnlne the remalning length of straight dutt aibwable.
B. If dexible dud Is used,inuease the duct dtameter by one kxh.Flexlbie duct shall be stretched with minimal sags.Compressed duct shall npt be aaepted.
t. Barornatrk dampnrs are prohibfted In passNe makeup alr opeMngs when any atmospherkally vented appltance 1s Instalfed.
0. Powered makeup atr shall be electrically Mterlodced with the largest exhaustrystem.
' t .
Sections F �
Combustion air
Not requlred per mechanical code(No atmospherk or powervented appliaoces)
Passhre(see IFGC Appendix E,Worksheet E•1) SiZe and type
Other,desaibe;
Exp/anatlon-!/no acmospheric or power vented app!lances pre/nstaped,check the approprlale box,noC requlred. !f a power vented
or atmasphericaity venied appllance lnsralled,use lFGCAppendlx E,Worksheet f-1(see be/ow). Please enter slze and type. Combus- �
tlon air vent supplles must communlcate with ihe applJdnce or appliances thai requlre the combusdon alr. �
Sectlon F calculatlons follow on the next 2 pages. '
i
�
• �
i
� 1
F'age 4 of 6
Christine Mattson
From: Adam Edwards
Sent: Tuesday, September 20, 2016 3:37 PM
To: Christine Mattson
Subject: RE:495 North Arm Drive/#2016-01030
Stamped approved
From: Christine Mattson
Sent: Monday, September 19, 2016 9:10 AM
To:Adam Edwards<aedwards@ci.orono.mn.us>
Subject: RE: 495 North Arm Drive/#2016-01030
Adam,
We received an updated survey for 495 North Arm Dr. Please review and provide comments.
Chris�
From:Adam Edwards
Sent: Friday, September 02, 2016 2:53 PM
To: Christine Mattson<CMattson@ci.orono.mn.us>
Cc: Roger Peitso<rpeitso@ci.orono.mn.us>
Subject: RE:495 North Arm Drive/#2016-01030
Chris,
I've reviewed the subject plan, stamped it approved with the following questions/comments:
1. The Development grading plan depicts at Swale beginning in the Northwest corner of the property and then
running parallel to the property line just to the south of the property line. This Grading plan does not depict the
swale. Was it constructed? See Image Below.
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2. I believe a driveway culvert will be needed at the connection with the roadway.
3. The Grading plan as an alternate septic site labeled in the Northwest corner but no boundaries depicted. If the
intent is to keep this as an alternate site the site will need to be protected during grading operations.
4. Perimeter sediment control measures should be installed by the Contractor and inspected by the City prior to
any work, including demolition. Contractor must provide minimum 24 hour notice prior to inspection.
Adam
From:Christine Mattson
Sent:Thursday,September 01,2016 2:03 PM
To:Adam Edwards<aedwards@ci.orono.mn.us>; Roger Peitso<rpeitso@ci.orono.mn.us>
Subject:495 North Arm Drive/#2016-01030
We received a building permit application for a new single family home at 495 North Arm Drive.
Adam has one set of the following:
Survey
Building plans
Landscape plan
Roger has the same, plus the rest of the file.
Please review and provide comments.
Thanks!
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway I Orono I MN I 55356(physical address)
z
PO Box 66 I Crystal Bay I MN � 55323-0066 (mailing addressJ
'a' 952.249.4620 � 8 952.249.4616
�cmattson@ci.orono.mn.us I �www.ci.orono.mn.us
Summer Office Hours: (Monday,May 23 through Friday,September 2,2016)
Monday-Thursday: 7:30 am to 5 pm
Friday: 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Monday,September 5, 2016
3
�^� � DATE TIME y
CITY OF ORONO cnLLED IN �
INSPECTION OTICED/�� SCHEDULED �
PERMIT N COMPLETED
ADDRESS � �
�AINER TELEPHONE NO. � '3 0'?��//
CONTRACTOR � ! . CS
� DESCRIPTION
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O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
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� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
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O�erlCor�tractor on site:
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�� DATE TIME
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Ca11 for the next inspection 24 hours in advance. (952) 249-4600
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INSPECTOR WILL RETURN
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O INSPECTION REOUIRED.CALL TO ARRANGE ACCESS_
ceq ror u�e next inspect�on za nou�s��►ance. (952) 249-4600
on site:
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Whiw Cop�llnp�ector's FlN C�nary Capr181la Notle�
� � DATE TIME
CtT�f QF ORONO CALLED IN � �
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� COMMENTS: �
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inspector /ti^-�
Whits CopyAnspector's Flle C�nary CopylSits Notice
�� ME
�� n �
CITY OF ORONO cnLLED IN
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OMINER TELEPHONE NO. 7
CONTRACTOR � S
� DESCRIPTiON
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_ ❑ AS BUILT-SURVEY ` ❑ R HOOK-UP ❑ FOUNDATIOWREMOVAL
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INSPEG`fOR WILL RETl1RN
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O INSPECTION REOUIRED.C/1LL TO ARRAN(3E ACCESS.
CaN br the next h�spectlon 24 hours in advanoa. (952) 249-4600
on site:
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emo
To: Finance Department
From: Christine Mattson, Planning Assistant ��
CC: Street File
Date: October 18, 2017
G/L: 101-22205
Re: Escrow Refund
Building Permit#2016-01030 pertaining to 495 North Arm Drive is complete. Please refund
$2,500 to the builder, Norton Homes.
Make check payable to Norton Homes
18215 45�'Ave N, Suite D
Plymouth, MN 55446
HOLD CHECK AND GIVE TO CHRISTINE
w:�street files�north arm dr1495�escrow retund 2016-01030.doac
Christine Mattson
From: Roger Peitso
Sent: Friday, October 13, 2017 10:47 AM
To: 'PatH@nortonhomes.com'
Cc: Christine Mattson; Laura Oakden
Subject: 495 North Arm
Pat,
We still have not Finaled the mechanical permit there because the kitchen fan had not yet been installed.Schedule a
final for the mechanical if the work has been done then we will be able to issue the Final CO when the final has passed
inspection.
Any Questions please call.
Sincerely,
City of Orono
Roger Peitso
Building Official
Phone:952-249-4600
Direct:952-249-4625
Email: rpeitso@ci.orono.mn.us
Fax:952-249-4616
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Christine Mattson
From: Christine Mattson
Sent: Wednesday, September 06,2017 11:56 AM
To: chrisn@nortonhomes.com
Cc: Roger Peitso; Monica Fadness
Subject: 495 North Arm Drive/#2016-01030
Chris,
We have received and approved the as-built survey for 495 North Arm Drive. However,when I went to process the
escrow refund request I see there are open permits. Please have the following completed:
Permit# Permit Type Inspections Required
2016-00513 Mechanical (Fireplace-Gas) Air Test& Final
2016-01205 Septic As-built& Final
2016-01030 New Construction Framing Re-inspection
2016-01030 New Construction Final
After the above has been completed, please contact me so I can process the escrow refund. Don't hesitate to contact
me with any questions.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway � Orono � MN � 55356(physica/addressJ
PO Box 66 I Crystal Bay � MN � 55323-0066(mailing addressJ
'�' 952.249.4620 I 8 952.249.4616
� cmattson@ci.orono.mn.us I � www.ci.orono.mn.us
Office Hours: Monday-Friday 8 am to 4:30 pm
OUR OFF/CE WILL BE CLOSED: November 10,2017
i
, BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permit# �(� 1 �(���
.�S� ������
AGREEMENT made this day of , 20!d , by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City") �1`�15 f�V��y-1 C Vl ("Owners").
Recitals
1. A building permit application has been filed a
�ISS /1%.�r+� q/'w� r�,� located at Gvt �.l �3���� 3 the ("Subject Property"), legally
described as
L�� bLl � /,3�oC� � , �a k..�?t)�e� a• � 1'U►'��
2. Owners request the City to review this application.
3. The City will commence its review of the application and incur costs associated with said review
only if the Owner establishes an escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE, THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit $2,500 with the City. All accrued interest, if any, shall be paid to the City to
reimburse the City for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City
for all out-of-pocket costs the City has incurred (including planning, en_qineerin_q, in excess of $500, or legal
consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the
Owners would be responsible for under a building permit application.The escrow will also guarantee reimbursement
to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in accordance with
the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79. The financial security
may also be used by the City to eliminate any hazardous conditions associated with the work and to repair any
damage to public property or infrastructure that is caused by the work (including planning, engineering, or legal
consultant review) associated with building permit # � (J 1(r — C> I C%.� if compliance with the approved
building permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn
send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners' receipt
of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment to
the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners pay all expenses
invoiced pursuant to#3. The City may draw from the escrow account without further approval of the Owners to reimburse
the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any,shall be returned to the Owners
when all requirements related to the project are complete. City Staff shall review the terms of this escrow agreement
two times per year to determine whether the requirements of the project have been successfully completed and
whether it is appropriate to return the funds. Owner may also request the release of the funds, and such funds shall
be released upon City Staff receiving the appropriate verification that all requirements of the project have been
successfully completed.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subject property pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: T O OWNER:
By: �!��s y�✓��--
�ts: , �'G 1��---.
Internal Use Only: G Original to Planning G Copy to Property Owner 0 Copy to Street File
Last Updated: January 2016
CHFtIST1AN NORTON 1$O�
4416 TRILLtUKA DR S
MEOINA,MN 5534p-q579 e� �7-tl9to6596
"'aG�e�-1` 2934900909
City of Orono ���e �
�a�e
2750 Kel ley Parkway pr�rof � • d� �r�d2�! � D�oj1'
Orono MN 55356 952-249-4600 ,�►-. �7
�• ` , ,;e,�.' ,�
� L �
Receipt No: 3.016525 Sep 26, 2016 � � �
. �n eankN.A. .. .
� ���
Chris Norton � ��
s Fo���/����.�� ,�>� �'�
� �
Previous Balance: .00 �:0 q L0000 19�: ■ ������4w��� �
Permits 2934900909�� 0 L809
2016-01154 495 N Arm Dr 2.500.00 �
101-22205 '
Deferred Rev-Developer Deposit
---------------
Total: 2,500.00
---------------
---------------
Check
Check No: 180.9 2,500.00 GHRISFG4NNORTaN
Payor: aaie t�+��n�►t+��R s 1$10
RAEDINA,MN 553qp-4579
Chris Norton / 1�,�
Total Applied: 2.500.00 ��s�-
--------------- �
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Change Tendered: .00 �°�e �j� _
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09/26/2016 01:22PM------------ "rr W 9� �
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,
� ` CITY OF ORONO * 2 0 1 6 - 0 1 1 5 4 *
2750 KELLEY PARKWAY DATE ISSUED: 09/26/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 495 NORTH ARM DR
PIN : 06-117-23-31-0014
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 21 BLOCK 3
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: ESCROW FOR NEW HOME PERMIT#2016-01030-PAID BY:NORTON HOMES-$2,500.00-CK#
APPLICANT ESCROW FEE-BUILDING 2,500.00
TOTAL 2,500.00
NORTON HOMES Payment(s)
18215 45TH AVE N,STE D CHECK 1809 2,500.00
PLYMOUTH,MN 55446-
(612)386-7661
Minnesota State License#:BUIL-BC639221
OWNER
Norton Homes
NORTON,CHRIS
18215 45TH AVE N
STE D
PLYMOUTH,MN 55446-
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
permiu. All provisions of laws and ordinances governing 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.
/ /
Applicant Perrr►itee Signature Date Issued By Signature Date
U / DTE TIME
CITY OF ORONO CALLED IN _
INSPECTION N TI SCHEDULED 5- °A/'0
PERMIT NO. < `076 COMPLETED
ADDRESS4/9-5- /1)- /41YYi ,nl V`e-
OWNER T•LEPHONE NO. ( 7_ 5q ay
CONTRACTOR AtiM0L !if AA / 4 i-'
DESCRIPTION C)4(4h
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
lc ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
O
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL ❑ RATED WALLS
❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
'14( 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
5 OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
it
oW. c? / 7evs to -felt -
o - 4) eep sc/eeJ3 ,l�iav ,bel
, sbcn ...-5 de,0. is oe_
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W 0 WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
CC
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W
ECT WORK&PROCEED El ISSUE CERTIFICATE OF OCCUPANCY
0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
t.) BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CI
O STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:,/
Inspector. ----?/lit
White Copyllnspector's File Canary CopylSlte Notice
' . 5P--,1—
ATE TItit/
CITY OFq3 ;ONO CALLED IN
INSPECTION . OTICE A/9 SCHEDULED 7-/7 f''
PERMIT NO.c 0 ? COMPLETED
ADDRESS I S v'7% < /Y ,47? )Il y
OWNERTE PHONE NO. / 0,e%-7gg
CONTRACTOR or
E DESCRIPTION 4R;tif /11/a)
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
12 0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
C
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING ❑ MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
`.1 0 WATER HOOK-UP 0 FOLLOW-UP
Lli rAL
BUILT-SURVEY ❑ SEWER HOOK-UP 0 FOUNDATION/REMOVAL
.1 ❑ DEMO-SITE 0 SEPTIC INSTALL
5 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
c COMMENTS: e..-& 'i/' 677/6 .84)4 1
4 - GG Cs— d.t.:/ r`-c:.rt ,f r.4/ 4: . ' - ?c u� -
C - t/ /4-w- /47 /v,-it,,./ 5 (/o'-.il l-I Y'-11 fL
0
W /1ia,94i/li0c 4i/:tOr0 ' /Ya,/t5 � . -7
Q _5M CU a i- c/Ci G/ /i57 c Th �f'7 -! /
.,:./.s•y�rh� , F�445 [irli7f2 /1 1i r�
Dr �i�.•/ dC.
A0 3 s (iI) flt1Vx/> 15 / 10 (&
W 0 WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE
CC
lar 0 CORRECT WORK&PROCEED ,6.I SUE C FICATE OF OCCUPANCY
C 0 CORRECT WORK,CALL FOR REINSPECTION (TEMPORARY
V BEFORE COHERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contra on ite:
Inspector: G.--�-_C/ ' cAr1
1 G/
White CopyAnepector's Fila Canary CopyASMe Notice