HomeMy WebLinkAbout2010-00069 - new structure CITY OF ORONO PERMIT NO.: 2oia00069
� 2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISSUED: 02/25/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2600 PHEASANT RD
PIN : 21-117-23-23-0023
LEGAL DESC : PHEASANT LAWN
: LOT 000 BLOCK 000
PERMIT TYPE : NEW STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SINGLE FAMILY
ACTIVITY : 101-SINGLE FAMILY HOUSES,DETACHED
VALUATION : $ 375,000.00
NOTE: SEPERATE PERMITS REQUIRED:PLUMBING, MECHANICAL,FIREPLACE,
WATER CONNECTION,SEWER CONNECTION,LAWN IRRIGATION,AND ELECTRICAL(STATE)
THEY PAID THE ADVANCED PLAN REVIEW ON PERMIT#2010-00068
SAC IS GRANDFATHERED IN
APPLICANT pERMIT FEE SCHEDULE 2,706.75
LECY BROS CONSTRUCTION STATE SURCHARGE(VALUATION) 187.50
15012 HWY 7
MINNETONKA,MN 55345 S.A.C. 0.00
(952)746-3783 TOTAL 2,894.25
Minnesota State License#:20325555
OWNER
HADDEN,TIMOTHY&JULIANN
2600 PHEASANT RD
EXCELSIOR,MN 55331-
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 sepazate
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 aze
re d in conformance w' e State Building Code.This permit may be
oke at any time for d ca .
� a�a�-� , �
App icanT Permitee gnature f,,,, Date Issued By nature , e
7!y•
SEPARATE RMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO E.
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� Plan Review Checklist for New Structures / Additions
Address/ PID/ Legai: S,� ���p�,p 2�4� �1��¢ r'�'l
Description of work: (`J l.� �;Cj
Septic review by: e =✓�! Date Approved:
Zoning review by: Date Approved: �� Z� 2U �- �
Building review by: Date Approved: z�Zz- 20� o
Grading review by: Il� Date Approved:
Zoning File#: ���'l�� > Resolution #: Resolution Date: ���� � �
Zonin District Fire Department Post Office School District ,
Zoning: Lot Area:-1�� � SF AC Width: �s V fUV� Depth:
� � �� ��
Survey Submitted: es 0 N Date of Survey: Z �
Pro osed S cks:
Fro (Lake) Rear(Street) N S E W ) ( N��S�E W ) Other Buildings Wet{and
' Side �ide
- � -I-� C UQ � ��
Building Defined Height: r� �
� Building Peak Height: �� # of Stories Ok?: YES
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
�j(p START WITH the distance between the basement floor/crawl START the distance between the slab and the highest
UZ space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof,
� the cornice of a flat roof, the deck line of a the deck line of a mansard roof,or the
mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type
or other arch-t e roof roof
SUB�C� half the distance between the highest window and SUBTRACT half the distance between the highest window
� hi hest roof eak of a itched roof and hi hest roof eak of a itched roof
SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest
�/ space floor and the highest existing grade within� � existin rade within the foundation
the foundation or 10 feet, w ic ever is ess. EQUALS Defined buildin hei ht
EQUALS Defined buildin hei ht
Lot Coverage: ` � �L��r0 SF �`Q o�o
Shoreland District MCWD Permit Received Avera e keshore Setback BI
�Yes ❑ No ❑ N/A ❑ Yes No
es ❑ No Yes No ❑ N/A
Permit Number. �d -�i�� Setback:
GlM VV� — ' ,Y,- ,YW� 2 �
Hardcover Zones Existin Prop sed a ance equired CUP Re u red
0-75' �-Z� � Yes ❑ No ❑ Yes o
75-250' ��(o� Ty e ): Type(s):
250-500' �Qg" j �,V���^� �pi
l.�- I � (iV��
500-1000' '
REMARKS (in-house):
Updated: 09/11/2009
z:\forms�plan review checklist.docx
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Fees to be Charged YES NO .
:Permit, - , ._
'_ �
Plan Review
State'Surcharge
Investigation Fee
SAG-.Number of'SAC:Units : _
Sewer Connection
`Water Connection -
Park Fee
Site Inspecfiom . _ ,. . , . , .:: , - ,. ,
Other (specify) , ,
'Misce:llaneous Fees'` ,, ,
Calculated By: � �
Square Foota e $ per Square Footage
Basement X = $
1 S` Floor X - $
2nd Floo� X - �
Garage X = $
Estimated Construction Value: $ 3'?S.DOc� °�
Orono Inspections Required Work Requiring Separate Permits Required State Permits
❑ Site �Plumbing ❑ Grading / Filling ,P��
❑ Hardcover Removal � Mechanical ❑ Fire ,Qd Electrical
,0'�Footing ❑ Septic .�(Water Connection
�Poured Wall �Fireplace �Sewer Connection
�'Foundation Survey ❑ Masonry p�Lawn Irrigation
�' Radon Rock Bed �Mfg.
�Framing ❑ Other(specify)
H" Insulation
�As-Built Survey
�YFinal
❑ Other(specify)
REMARKS (in-house): ����'��� G�� N�cG�-�
Other Review: Reviewed by: Date Approved:
Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO
REMARKS (TO BE NOTED ON PERMfT AND INITIALLED BY PERSON PULLING PERMIT)
Updated: 09/11/2009
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City of Orono '
� � Building Permit Application
for New Structures or Additions
Mailing Address: Permit number. L L.' �� - � �C ,(�`
�.,��� PO Box 66 �
Q �,\ �\ Crystal Bay, MN 55323-0066 Date received: �' ' ! ( /C
.`� 1
� a �'� � �, Street Address:' �—�-'fC�— �����`� Received by: (=_'_T_�
t 4.'•y J
�� ������'"��, Gti/ 2750 Kelley ParkwayL'�L� Z����1�,� plan review fee: i, ��`j �� � �
��k�1fi\�04� Orono, MN 55356
Esx �
' Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and alI required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATIONr�?(;,��;(_:� i�= �,\� �-,Z,y�,-��- �
Job Site Address: � � �(,� -
Will this be a Parade of Homes, Remo elers Showcase Home or other Display Home? ❑ Yes �No
If yes, a specia!event permit is required with Police Department and City Council approval 60 days prior to fhe event. Shuttle bus service wi(1 be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: fl_��f Q,�� �ow��s
State License# ac�3�SSS5 Expiration Date: 3 -31 —��
Phone: _ � office y _qqd�- 4�tQ cell)
Mailing Address: -7 Cit : H nJ� ZIP: 55
Contact Person: ��y ,��(,�,��� Applicant is: ontractor / Homeowner (Circle One)
Email and/or Fax: � c�c,,�—c���_ �pbg
PROPERTY OWNER INFORMATION:
Name: �'c�..��� � Ju.lcc�tiv� ��r.�e�n
Phone (day): a,-- S _ �7o,c�
Address: ��SS �� Y ��� �, City: o�ro�no ZIP����3�
Email and/or Fax
ARCHITECT/ ENGINEER INFORMATION:
Name: �ot.v�C, a�S �.ovr�-'�'b�r
Phone (day):
Address: Cit : ZIP�
Email and/or Fax:
PROJECT INFORMATION:
1. Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal 8�
�New Construction Water Supply �
�Single Family with �esidence
❑ Addition attached garage ❑ Garage/Accessory Bldg. f�Public Sewer �
❑ Accessory Building ❑ Single Family with ❑ Deck �
❑ Relocation detached garage ❑ Office/Commercial �
� P fY) ❑ Mul�i �e Famil /Condo ❑ Private Sewer
❑ Other: s eci �
p y ❑Warehouse
❑ F�blic ❑ Storage �Public Water
*"Any earth movement may require ❑ Commercial ❑ Other(specify)
MCWD review&permits. ❑ Industrial ❑ Private Well '
Minnehaha Creek Watershed District(MCWD) ❑ Other. (specify) �`
18202 Minnetonka Blvd �;
Deephaven, MN 55391 ,
Phone: 952-471-0590 `4�;
Fax: 952-471-0682 �
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ 3"j �'"-�', d� � j
Last Updated: 9/29/2009
- 17 -
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STRUCTURE INFORMATION: "
1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction
a. Length (ft.)= �19 } Number of bedrooms= �' �Wood/Frame
❑ Masonry
b. Width (ft.)= SZ t Number of garage stalls: ❑ Metal
Attached =�_ ❑ Pole Bldg.
Areas in square feet Detached = ❑ ICF
g2 F,µcs�.,.1 ❑ On-site Prefab
c. Basement= �503 �c.n�n� ❑ Off-site Prefab
d. 151 Story = ( 8 ❑ Other(please specify):
e. 2"d Story = i�a4
f. '/Story =
g. Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed Applicable
� ❑ Permit A lication
� ❑ Pro osed Buildin Plans
� ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
� ❑ Surve meetin all re uirements
� '� Stormwater Pollution Prevention Plan
� ❑ Hardcover Calculation(s
� �- Se tic S stem Site Evaluation Re ort
❑ � Access Permit
� �. Wetland Buffer Im rovement Plan
� � En ineered Plans for Retainin Walls 4 feet or above
� ❑ Plan Review Fee
� ❑ Other
APPLICANT 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;
• 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.
ApplicanYs Signature: � Date: �—�-1�
� ��° �� -
Last Updated: 9/29/2009 - "
- 18 -
T0:9529�2106E 2010/82/05 11:15 P�:2
,
N�;iw Construction Energy Code Comptiance Cer�ificate
Per Nl 10 t R Huilding Cert�cate A Mulding ccrtiticate shall be posecd in a rx�ananently visible location inside pate Certtlla�ee porqA �p��P�
thc bwld2ng '1'he cemf�cate shAll be ccunrleted by thn builder and sha11 list informytion az,d values c>f
com cnts listed in T'able N1101 R p�BCe y0�r,
f
M.111o�AdMN�dt4eDw�4loKorDwdlm�UNt .� � � �� � / �� � �e�e
� tr,G l'C Q�:_Y'�� qb
S'S� ...,���cr ��� �,�_! ��-o�,0 9
tvmr a!lie�Id�aWl Ca.tr�eror MN Llowr Naiubrr�
� \'_.'�\ `:`� � �Y�Y�7L=.�7 �� �l ����5
THERMAL ENVELOPE RADON SYSTEM
Type:CheCk All That Apply Passive(No Fan)
0
F� � M/ive(W�th fan and monomeler or
� � other,syslem monitoring device)
q. � � � �
� ¢ � C7 �' � rc � �,
Insutatfon Loc�tio� �' o z � � � "
cti •� o cu �' `t' w .°�
� H C � .�° � � � � �
t-° a� � �i. ti. w w° � 'a� i� Other Plc�[kscxibc Rcrt:
Belwv Enrire Sleb �—
Fuundation Wall
Typt m location.intenor extedor or integra�
Pe�eter ot S7�b oh Grade �
x�J������� — Type in locabon:interior exterior or iM�gral
RlII1.1018t(1 ��OpP/-) Typ�in Ixation��rtt�nor wxtenor o�integial
Wall
CeWn ,tlst a_ �
Cel1i�►�,vaukcd � ��
�-�3
Bry Window�s or cantllcvernl areaa
Bonus room over wa e _3�y
Desc�ibe otLer ituuL�ted areas �,,(/�
Wlndows a poors Heating or Coolin Ducts Outside Conditioned 8paces
Avcra e U-Paclor(erclude.s skyliRhts and une door)U: l0 Not Iicable,ali duclr locatzd in canditioned s �e
Solar H..at Gain Coefficicnt(SHGC): ' R-value
=�i i
MECHANICAL SYST MS Make.up Air Selei�t Q Type
liances Heati System Domeyi�c Water lieater Coolin S /V� Not re uin�[ r mecb.code
Pue11'
�C /i' Passiv�
Mannfact�rer �
�� Y� � Powered
Model S J�Ipf/G O�/ �t�lockedwith exhau�t device.
p 6d ��C1 ,�,;n�:
ic�pu�in r.apaccty�� <wc�xu u� s,,,, ocher,desa;tx::
ItatlnR or Siu Fi'rUs: �Gb fXJI�G�Jtcxu; T�„y: � �v/�l
1-leat l.oss: lleat Gsin I.cxaLion oFduct or sVslem:
strncture'e Ca►culatea 7 9�l SO y/3
N���Of SCER /V I�
HSI,Fro,o f3
9a�o �����,at�d
Efbcienc
�r ��a ��// I!'/XJ ct;��y
� "mund ciuct OR
MeChanical Ventilation Sysfem
"metal du�K
ll�cc.'ribt:any additicmal or combinc.d hcating or cooling systems i1"iz�sla]loci:(e.g.two[urnu,;,,,w or air COmbusti�n Air Settct a Ty .
�uru;heat pump with gav back-up fumaco):
Selux T c
Not reyuired�x-r mech.cafe
{�Pasxive
Heat Recover Ventilator(IiRV) Ca ac;itv in cfm:c; �,�H,; F��
Olhe.v,datic.-ribe:
L' Rccover Vc,�nti�ato�(FRV}Ca acil�+in c6ns; (_,o��,: t.�� 0 I.ocation ofdud or sysl��'".
Cotttinuous cxhauctin fen(s)rated capacii �,�: me�.�t.. Roo�'�"�
(,cKation offan(x),drsc�ilx:: O'Q Cfnis
C: itV nmtinuous ventilatirnf ratc ir�cMw: �Gj "round du�Z O}t � e X
'Cotal vd�tilation(incemtirient +��nuous)rate in cftr�y: "metal duc.-t
rea y ve�on
•
Building Permit Fee Estimation
for valuations greater than $500
Valuation �
375,000
Permit Fee Surchar e Plan RevieVjr Total Fees
2,706.75 187.50 :' 1,759.�€7 4,653.64
Total if No Plan Revie 2,894.25
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hFi:r.t' ('4i�: �✓.
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CITY OF ORONO CALLED IN ���'�" �v
INSPECTION N �j�_�D�SCHEDULED Qy����� ✓� �
PERMIT NO. �COM ETED —
ADDRESS a
OWNER TELEPH NE NO.�` a- ���-" vJ
CONTRACTOR
>: DESCRIPTION `•�� `
��'FOOTING ❑ PLUMBING FIN ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL ❑ LAKESHOREM/ETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q � RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP O COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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SATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail forthe next ins ction 4 hours in adv�nce. (952� 249-46�0
OwnerlContractor on site:
Inspector. '
White Copy/lnspector's File Canary Copy/Site Notice
�� �`� � D TE TIME �
CITY OF ORONO CALLED IN � ��
INSPECTION NOTICE SCHEDULED �
PERMIT NO. � -� 9 PLETED
ADDRESS �
OWNER T EPHONE NO��" �
CONTRACTOR S'
>; DESCRIPTION � G�C�_
�
l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� �1 POURED WALL � MECHANICAL RI ❑ LAKESHORENVETLANDS
Q n
Q(❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑INSPECTION REQUIREO.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-460�
OwnerlContractor on site:
Inspector._�,!
White Copy/lnspector's File Canary Copy/Site Notice
� DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED '�0 O;
PERMIT NO. �OID "ODO�OQ' COMPLETED
ADDRESS a��0 Qh-Q-C�Oa-�`� ��
OWNER TELEPHONE NO.��Z-70� ZZSO
CONTRACTOR � ��S - �'� -
a DESCRIPTION �����G - �e G�
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Z
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTNACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN
1NSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� Z49-46��
OwnerlContractor on site:
Inspector. _�� � �
White Copyllnspector's File Canary Copy/Site Notice
�V �� DA E TIME `�
CITY OF ORONO CALLED IN �''�• �
INSPECTION/N1�aOTICE SCHEDULED 4 2�•l0 :'�
PERMIT NO. IJJ� � ��Q COMPLETED
ADDRESS Z�0 �Q�Qy1,t' KIO�
OWNER TELEPHONE N0.��2'- 7� ��-�-�
CONTRACTOR �rV l�I ULCI� ��YOS YY1'��
>: DESCRIPTION �
� ❑ FOOTING ❑ PL BI FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECH ICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
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Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. �
White Copyflnspector's File Canary CopylSite Notice
L��/o �Q �'''
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White Copyllnspector's File Canary CopylSite Notice
DATE TIME
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