HomeMy WebLinkAbout2017-00212 - demo CITY OF ORONO I I' I' ' I 1 1 111 1 11
* 20 1 7 - 0 0 2 1 2 *
2750 KELLEY PARKWAY
DATE ISSUED: 03/3U2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 585 ORCHARD PARK RD
PIN : 31-118-23-14-0001
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : DEMOLITION
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DEMO-PRINCIPAL STRUCTURE
ACTIVITY : 645-SINGLE FAMILY HOUSES(ATT&DET
NOTE:
1. FOUNDATIONS/ALL DEMO DEBRIS TO BE REMOVED FROM GROUND&DISPOSED OF OFF SITE,PER PCA REGULATIONS.
2. WELLS MUST BE ABANDONED.
3. INSPECTIONS DONE BEFORE BACKFILLING.
NOTE: A 24-48 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. CALL(952)249-4600.
SEWER MUST BE DISCONTINUED AT THE CITY SERVICE BY QUALIFIED CONTRACTOR BEFORE DEMO PERMIT IS ISSUED. CHECK
TO MAKE SURE THIS PERMIT HAS BEEN PULLED BEFORE ISSUING THIS PERMIT.
APPLICANT DEMOLITION-PRINCIPAL STRUCTURE 75.00
TJB HOMES INC STATE SURCHARGE DEMO 1.00
9100 BALTIMORE STREET NE TOTAL 76.00
SUITE#102 Payment(s)
BLAINE,MN 55449- CREDIT CARD 4870 76.00
(763)780-2944
Minnesota State License#:BUIL-1845
OWNER
MALLAK,MICHAEL&SARAH
585 ORCHARD PARK RD
LONG LAKE,MN 55356-
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 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.
31 / 17
Applicant Permitee Signature Date Issued Byaignature Date
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lit�� City of Orono F R CITY USE ONLY
P.O.Box 66 Date Received: 3 Ji i I 1 Permit# 2017— G-i
2750 Kelley Parkway l -
Crystal Bay,MN 55323 Amount: $ ��dit:'r ' iS
(952)249-4600 V U' •"
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` Homeowner(s)Signed: ❑Yes
F �� Resolutions(if any)Signed:❑Yes ❑None Required
`lKEs H Oitt Zoning Disclosure Signed: ❑Yes 0 None Required
(Y 74( E
CITY OF ORONO - DEMOLITION PERMIT
(All permits must be approved by the Building Official and/or Zoning Department)
Job Site / Owner Information:
Type: ,'Residential ❑ Commercial
Site Address: 6E5 C) Vqkc 4 &,rc_ 'Kd
Owner: ;& 4, ,rc� VI/lalai/ Mailing Address: ,&. 1'Par . 3
City: CA(ZtMO Zip:
Phone: -14,3 "2c-{2-L/gFrI Email:
Contractor/Applicant Information:
Contractor/App.: pyo (., Contact Person: getmite
Address: 9/150 t -.y, dfe_ (-. nE State License #: /g/q
City: ktNett--- Zip: 51/4/9 Expiration Date: 3-/7
Phone: 163-7E6-Z6/yq Email:. 10711 1t herrne6. (��y,�
( q9-f')
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions:
1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc.
2. Work must not begin unless the permit card is available on the job site.
3. A 24-48 hour notice is required for all inspections. Call (952)249-4600.
4. Sewer must be discontinued at the City service by qualified contractor before demo permit is issued.
Demolition by means of: ❑ Manual Disassembly SKI Heavy Equipment ❑ Other
Permit(s) Issued: ❑ r Risconne�ctiioon-1C1 gWell Abandonment#
*I__,
In return for issua ce of said Demolition Permit, the undersigned owner hereby agrees to:
1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which structures are
to be demolished.
2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in accordance with
Chapter 79, Construction Site Runoff Control.
3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The City will
not issue a demolition permit without a copy of the permit(s) from the MCWD or documentation stating
permit(s)are not required.
Form Last Updated: July 2015 IO —5 ICI
150784
4. Submit a $2,500 escrow and an escrow agreement signed by the property owner(copy attached).
5. Keep all structure(s)enclosed and/or secured until such time as demolition is complete.
6. Keep all demolition debris off adjoining property and/or the public rights-of way unless specific prior
approval is obtained in writing for temporary use thereof.
7. Completely remove foundation(s)from the ground.
8. Completely dispose of all demolition debris off site in accordance with all applicable PCA requirements.
9. Abandon water wells in accordance with State Health Department regulations.
10. Call for an inspection when all debris has been removed, before backfilling.
11. Within 5 working days of superstructure removal, a final inspection shall be requested. The site shall be
left clean and clear of all debris, with any excavation filled with earth level with the adjacent ground
elevation (except when such excavation is to be used as part of a new building and such new building is
actually under construction).
12. Abandon septic systems per Minnesota Rules Chapter 7080. All septic tanks must be pumped, crushed
and filled with native soils. An inspection is required after the tanks are pumped and before the tanks are
crushed and filled.
13. The undersigned owner shall and hereby does indemnify and hold harmless the City of Orono, its agents,
employees and assigns from and against all claims, damages, losses or expenses, including attorney
fees, against the City, its agents, employees and assigns arising out of or resulting from the demolition
described herein as performed by the property owner, his employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
X $75.00 — Principal Structure $ 1‘,oo
(l $50.00 —Accessory Structure x (how many)
1. Subtotal of above permit requested $ 7clip
2. State Surcharge 1.00
3. TOTAL PERMIT FEE (add lines 1-2 above) $ 76. 00
The undersigned herby applies to the City of Orono for issuance of a Demolition Permit, agrees to do
all the work in a strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and correct.
Applicant's Signature: Date: 3-3—n
Owner's Signature: i// �� _ Date: 3 7` 17
Approved By: ` ,-- Date: 3 if /
Building Official)
* Zoning Disclosure Required? ❑ YESNO 2.O(, ��
*This must be filled out by Zoning Department—For er answer, a Zoning Official must sign all applications.
*Approved By: �� Date: _ 5 50 .17
( oning Official)
Form Last Updated: July 2015
150784
TL Erickson Enterprises
13170 Gemstone Ct c'�s
Apple Valley, MN 55124 NAT-29630
612/325-4393
floyd58523@gmail.com
March 8, 2017
TJB Homes, Inc.
9100 Baltimore St NE
Blaine MN 55449
612/275-7109 John@tjbhomes.com
RE: Proposal, House
585 Orchard Park Road, Orono, MN
Erickson Enterprises proposes to remove the identified asbestos containing materials
from the house at the above address prior to demolition.
Window glazing old windows $ 275.00
Transite panel by furnace in basement $ 325.00
Work to be completed in accordance to Federal, State and Local rules and regulations.
Price includes permits as needed, labor, materials and disposal.
If you have any further questions,please call me at 612/325-4393
Sincerely
Todd Erickson
President
TL Erickson Enterprises
SAF;
13170 Gemstone Ct of
? ,r, a )�
Apple Valley, MN 55124 MAT-29830-1
612/325-4393
floyd58523@a,gmail.com
March 8,2017
TJB Homes,Inc.
9100 Baltimore St NE
Blaine MN 55449
612/275-7109 John@tjbhomes.com
RE: Pre Demolition asbestos survey, 585 Orchard Park Road, Orono, MN
TL Erickson Enterprises completed a pre demolition survey of the house at the above address. The house is
a 2 story house with an unfmished basement. All areas of the house were available for inspection. Walls
and ceiling cavities were inspected and no vermiculite insulation was located. Gray transite panel in the
basement and cream window glazing. The Cream Sheetrock compound was composite sampled and
contains less than 1%asbestos containing material for demolition
Samples were taken from the following areas.
Exterior white caulk around windows no asbestos
Basement above furnace Gray transite panel CONTAINS ASBESTOS
Main floor white 2x2 ceiling tile no asbestos
Kitchen brown flooring with tar paper backing no asbestos
Basement brown mastic no asbestos
Basement yellow mastic no asbestos
Basement red mastic/leveling compound no asbestos
Basement black tar paper no asbestos
Basement gray flue packing no asbestos
Basement white gasket on furnace no asbestos
Basement orange gasket on furnace no asbestos
2nd floor gray wall/ceiling plaster no asbestos
2nd floor white lx1 ceiling tile no asbestos
2nd floor cream window glaze CONTAINS ASBESTOS
2nd floor cream sheetrock taping compound THE TAPING
COMPOUND WAS COMPOSITE TESTED AND IS LESS THAN 1%ASBESTOS FOR DEMOLITION.
ANALYSIS PROCEDURE
The samples of suspected ACM collected were taken to the laboratory of Techtron Engineering,Inc.
Anoka,MN. Laboratory analytical procedures are as follows.
Analysis for the presence of asbestos fibers in bulk samples is performed using polarized light microscopy
(PLM)and dispersion staining techniques. The analysis was performed suing and Olympus BHSP
microscope at 40-200x magnification in accordance with U.S.Environmental Protection Agency(USEPA)
protocols,"Method for the determination of Asbestos in Bulk Building Materials,"EPA 600/R-93/116.
The National Institute for Standards and Technology(NIST)accredits Techtron laboratory. Their
accreditation AIHA-LAP,LLC#is 101106
Recommendations:
Asbestos: Remove identified asbestos containing materials prior to demolition.
Sincerely;
Todd Erickson
Minnesota Asbestos Inspector AS523 Lead Certificate Number R-I-18315-10-01331
•
PI
11)(• ASBESTOS
OR
ANS
pe4 NW sant Da. No AS23 issued 07/200016
. I1'I* ASBESTOS
ME ,,
cowisobk SUPERVISOR
atn
Expos:`-Thi .
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=. Tana
.Health DM- No A5523 Issued:07120/2016
i
TECHTR•N
engineering inc.
environmental solutions
March 7, 2017 640 East Main Street
Anoka, MN 55303
TL Erickson Enterprises Phone 763.712.9502
13170 Gemstone Ct Fax 763.712.9504
Apple Valley MN 55124
www.techtron.biz
Project Location: 585 Orchard Park Road, Orono, MN
Techtron Job#: PLM-17-26794 Analyzed by: C. Schueller
Date Samples Received: 3/6/17 Date Samples Analyzed: 3/7/17
Number of samples submitted: 11 Number of samples analyzed: 15
Test Report: Asbestos Bulk Materials Identification by PLM
Following are the results of material samples obtained for asbestos identification analysis. Samples
were observed at 30X and suspect fibers were picked from the bulk samples and observed under
polarized light microscopy. The fibers were then evaluated under crossed polars for extinction angle,
sign of elongation, and morphology. Dispersion staining techniques using different Cargille liquids and
observing colors at two different orientations of the crystal were then performed.
Analysis was performed according to EPA method 600/R-93/116. This method detects asbestos in
volumetric concentrations of 1% or greater. Bulk samples were checked for the following types of
asbestiform minerals: chrysotile, amosite, crocidolite, anthophyllite, and tremolite-actinolite.
Client Lab ID Sample Location Sample Description Asbestos Results
1 102129 Exterior White Caulk around Windows NAFD
2 102130 Basement above Gray Transite Panel 20-30% Chrysotile
Furnace
3 102131 Main Floor White 2'x2' Ceiling Tile NAFD
4A 102132 Kitchen Brown Flooring with Tar Paper Backing NAFD
4B 102133 Basement Brown Mastic NAFD
4C 102134 Basement Yellow Mastic NAFD
4D 102135 Basement Red Mastic/Leveling Compound NAFD
4E 102136 Basement Black Tar Paper NAFD
5 102137 Basement Gray Flue Pack NAFD
6 102138 Basement White gasket on Furnace NAFD
7 102139 Basement Orange Gasket on Furnace NAFD
8 102140 2nd Floor Gray Wall/Ceiling Plaster NAFD
9 102141 2nd Floor White 1'x1' Ceiling Tile NAFD
10 102142 2nd Floor Cream Sheetrock Compound 2-3%Chrysotile
11 102143 2nd Floor Cream Window Glaze 2-3%Chrysotile
NAFD = No Asbestos Fibers Detected
Laboratory Manager,
Charles Schueller
Reporting Limit:1%.Some samples reported as NAFD may contain asbestos fibers in quantities below 1%.Detection limits are dependent
upon the sample size,matrix,and any interferences that may be present in the sample.Point counting is recommended for samples that
require more precise quantification when samples contain low volumes of asbestos fibers(i.e. 1-5%).Results are based on field sampling
information provided by the client and are only valid for samples tested.Samples are stored for 30 days unless other arrangements are
made by the client.Samples received in good condition unless otherwise noted.This report shall not be reproduced except in full,without
the written approval of Techtron Engineering.AIHA-LAP,LLC Lab#101106.
Page 1 of 1
f 12/28!2016'12:00 AM.METJ Mechanical-Rough In P Y 2016-01559 585 Orchard P 7 R 1 ' Y `
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319/2017 12:00 AM t ROB Manometer Test with Final P V 2016-01487 585 Orchard Park Rd Mechanical [Residential Mechanical-Multiple
3!9!2017 12:00 AM ROB Mechanical-Final P I Y 2016-01487 585 Orchard Park Rd Mechanical f Residential Mechanical-Multiple `
11!162016 1200 AM;METJ Plumbing-Rough In P Y 2016-01428 585 Orchard Park Rd Plumbing _ Residential .Fixtures-Multiple
3/7/2017 1200 AM:METJ Plumbing-Final ,Y 2016-01428 585 Orchard Park Rd Plumbing Residential [Fixtures-Multiple
12/21/2016{1200 AM METJ Plumbing Air Test P :V 2016-01428 585 Orchard Park Rd Plumbing Residential Fixtures-Multiple
1t13/2017 12:00 AM ROB Plumbing-Rough In P Y 2016-01428 585 Orchard Park Rd Plumbing ;Residential I Fixtures-Multiple
3292017 1200 AM METJ Plumbing-Final—
P V 2016-01428 585 Orchard Park Rd Plumbing Residential Fixtures-Multiple
Pre Rough-Up 2016 01419 585 Orchard Park Rd Septic tResidential [Septic(New or Replacement)
{Rack Bed or Trench 2016-01419 585 Orchard Park Rd Septic Residential Septic(New or Replacement)
As-Built Hand Drawing 2016-01419 585 Orchard Park Rd Septic 'Residential Septic(New or Replacement)
I Final 2016-01419 585 Orchard Park Rd Septic Residential Septic(New or Replacement)
I e Jar Tests(3) i 2016-01419 585 Orchard Park Rd Septic Residential j Septic(New or Replacement)
2t1/2017 1200 AM ROGP Tanks!Septic P 'Y 2016-01419 585 Orchard Park Rd Septic — Residential Septic(New or Replacement)
3292017 12:00 AM METJ 'Pump&Alarm P 'Y 2016-01419 585 Orchard Park Rd Septic ;Residential Septic(New or Replacement)
10/26/2016 f 12:00 AM ROGP 'Demo Pre-Walk Through P Y 2016-01346 585 Orchard Park Rd Demolition j Residential 1 Demo-Accessory Structure ti
Final , 2016-01346 585 Orchard Park Rd Demolition 'Residential !Demo-Accessory Structure
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Escrow Refund Requested t 2016-01181 585 Orchard Park Rd Escrow Fee-Tied to Building Permit �Residential j Escrow Fee-Tied to Building Permit
Escrow Refunded I 2016-01181 585 Orchard Park Rd Escrow Fee-Tied to Budding Permit I Residential I Escrow Fee-Tied to Building Permit
10/26/2016 12:00 AM ROGP Silt Fence(Instated&Inspected) P .V 2016-01180 585 Orchard Park Rd New Structure {Residential Single Family
11/32016 112:00 AM MARK Footing(or Rebar) P Y 2016-01180 585 Orchard Park Rd :New Structure Residential Singh Family
Radon Rock Bed(Poly) 2016-01180 585 Orchard Park Rd New Structure Residential Single Family
11/7/2016 112 00 AM METJ Poured Wall(Foundation) P I Y 2016-01180 585 Orchard Park Rd 1New Structure Residential *Single Family
11/11)2016 12:00 AM ROB Foundation Water Proof(Drain Tile) P Y 2016-01180 585 Orchard Park Rd New Structure Residential Single Family
11/10/2016'12:00 AM I CMAT Foundation Survey B/4 Water Proof P 2016-01180 585 Orchard Park Rd New Structure I Residential Single Family
12/22/2016 12:00 AM ROB Framing P Y 2016-01180 585 Orchard Park Rd New Structure Residential Single Family
12/29/2016)2:00 AM ROB Insulation P Y 2016-01180 585 Orchard Park Rd New Structure Residential Single Family — —
2/21/2017 12:00 AM METJ Lath P Y 2016-01180 585 Orchard Park Rd New Structure Residential Single Fnily
3292017 12:00 AM METJ Final P Y 2016-01180 585 Orchard Park Rd New Structure Residential Single Family
As-Built Survey _ . 2016-01180 585 Orchard Park Rd New Structure ,Residential Single Family
Escrow Refund Requested 2016-01180 585 Orchard Park Rd New Structure Residential Single Family
Escrow Refunded 201601180 585 Orchard Park Rd New Structure Residential Single Family
1/24/2017 1 12:00 AM I METJ Poly or Vapor Barrier P Y 2016-01180 585 Orchard Park Rd New Structure Residential Single Family
3292017 112:00 AM I ROB PlL. umbing-Final P Y 2016-00394 585 Orchard Park Rd Plumbing Residential Water Softener €�
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City al 07Gi1
SITE PLAN d_ GRADING PLAN I Planning &Toning
• ®-APPROVED i
. .....•r.. ....T...,r..I.,....IA Site Plan Review