Permits - Permit# 24SP-00127 - 3832 Northern Avenue - 11/26/2024City of Spring Park
Demolition Residential
4349 Warren Ave, Spring Park, MN 55384
Phone:(952) 471-9051 Fax: (952) 471-9160
For Inspections: (952) 442-7520
24SP-00127
Date Issued:
11/26/2024
Property Owner: AK ENTERPRISE LLC / Anan Barbakawi
Expiration Date:
05/25/2025
Mailing Address: 9601 HUMBOLDT AVE S
Job Site Address:
3832 NORTHERN AVENUE, SPRING
Category:
PARK, MN 55384
Residential Miscellaneous
BLOOMINGTON, MN 55431
Phone: (651) 890-9694
Permit Type:
Valuation:
Demolition (Residential)
$15,000.00
Email: rosibelm.semaintemational@gmaii.com
Description of Work:
Demo
Subdivision:
Required Setbacks:
Parcel ID:
1711723330138
Filing:
Lot:
3
Actual Setbacks:
Block:
Total Sq Ft:
Contractors:
Fee Items Amount
Primary EDDE CONSTRUCTION LLC (651) 485-6760
State Surcharge $ 7.50
Residential Demolition Permit $ 333.25
Lead Certification Look -up $ 5.00
Residential Demolition Plan Review $ 216.61
Total Fees: $ 562.36
NOTICE
Signature of Applicant/Date
Building Department Signature/Date
11/26/2024
MUST BE POSTED ON JOB SITE
INSPECTION CARD
41 i�' City of Spring Park
SPRING 1%RK
On L*Winnemb 4349 Warren Ave, Spring Park, MN 55384
POST THIS CARD IN A SAFE CONSPICUOUS LOCATION. PLEASE DO NOT REMOVE THIS NOTICE UNTIL ALL REQUIRED WSPECTIONS ARE MADE AND SIGNED OFF BY THE APPROPRIATE
AUTHORITY AND THE BUILDING IS APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANS MIDST BE AVAILABLE ON THE JOBSITE
Demolition
APPLICATION NO.: 24SP-00127 TYPE: (Residential) ISSUED DATE: 11l26/2024 EXPIRATION DATE: 05/25/2025
1711723330
PROJECTADDRESS: 3832 NORTHERN AVENUE, SPRING PARK, MN 55384 PARCEL NO.: 138
AK ENTERPRISE LLC / Anan
OWNER: Barbakawi CONTRACTOR: EDDE CONSTRUCTION LLC CONTRACTOR PHONE: (651) 495-6760
DESCRIPTION OF WORK: Demo
CONSTRUCTION TYPE:
OCCUPANTLOAD:
DATE
INSPECTION INSP PASSED COMMENTS
Pre -Demolition
Reports
Fire Approval:
PW Approval:
To request an inspection: (952) 442-7520
Date:
DATE
INSPECTION INSP PASSED COMMENTS
Debris Removed
Building Final
Engineering
Approval:
Date: Other ( ):
Date:
Date:
Page 1 of 1
.!"
PARK
Project Name:
Date:
Jurisdiction:
ID:
Applicant Phone:
Jobstte:
Code:
Reviewed:
10/24/2024
City of Spring Park
24SP-00127
(651) 485-6760
3832 NORTHERN AVENUE
City of Spring Park
4349 Warren Ave
Spring Park, MN 55384
Phone (952) 471-9051
Fax (952) 471-9160
Approval Status: Resubmittal Required
Construction Type:
Applicant Name: Edde Construction - Ingeun Yu
Applicant Email: eddecontractor@gmail.com
2020 1309, Minnesota Residential Code
Building
The plans and specifications, for the project named above, have been reviewed for substantial compliance with the
current Minnesota State Building Code. This review is limited to the submitted scope of work; is based upon the
supposition that the data on which the design is based are correct and that the necessary legal authority has been
obtained to construct the project. Although every attempt has been made to identify code issues or concems for proper
and necessary change, the project designer(s), the building contractor(s) and the property owner(s) are ultimately
responsible for providing complete code compliance and maintaining minimum construction standards for the
safeguarding of life or limb, health, public welfare and property while constructing this project
The following items are related to the submitted plans/scope of work and are found to be either noncompliant with the
Minnesota State Building Code or additional information is needed. Please respond by letter of verification and/or revised
plans or addenda identifying corrections have been made. All comments shall be resolved before the building permit can
be issued.
If you have any questions or concerns regarding this plan review, please contact me via telephone at (952) 442-7520 or
email at codereview@mnspect.com.
Kevin Kamerud
Plans Examiner
(952) 442-7520
kkamerud@safebuilt.com
3832 NORTHERN AVENUE Page 1
r►^
PARK
MMIT. ... 1
Building: Resubmittal Required - Kevin Kamerud, kkamerud@safebuiltcom
Please see the attached Structure Demo handout for additional require information.
City of Spring Park
4349 Warren Ave
Spring Park, MN 55384
Phone (952) 471-9051
Fax (952) 471-9160
3832 NORTHERN AVENUE Page 2
7520
i ' , N P -r Phone: 442- 2-"'Fax: 952-442-7521
Email: info mns ect.com
DEMOLITION (Structures)
➢ Permits are required for demolition of building structures and/or interior building demolition work.
➢ If a new structure will be built immediately following the demolition of the old structure, all the work may
be on one permit The valuation of the demolition work should be included in the valuation of that permit.
➢ Along with the completed Building Permit Application, submit:
o The Checklist for Demolition Permit (attached), MUST be included with the application.
o ALL DOCUMENTATION listed in the Checklist that applies to your project MUST be included
with the application. If the structure is regulated, you must submit a Notice of Intent to Perform
a Demolition (attached) to the Minnesota Pollution Control Agency, and submit proof of this
step with your Application. (Single family dwellings are generally exempt from this requirement.)
➢ It is the responsibility of the owner and/or contractor to comply with the requirements and rules of
all authorities and government agencies having jurisdiction. The permit applicant shall be
responsible for contacting all of the proper State, County and Local authorities prior to beginning
demolition. All asbestos and other prohibited materials shall be removed and disposed of in
accordance with the rules and regulations established by the Minnesota Pollution Control Agency.
The Department of Natural Resources, County Environmental Services Department, County or
Local Watershed, Municipality Utilities and Public Works Directors are examples of agencies
and/or authorities that may be involved in any given project, and a demolition permit issued by the
Building Inspections Department shall not be construed as permission to proceed without approval
from all appropriate agencies.
➢ Information from the Minnesota Pollution Control Agency is included at the end of this document
for your convenience. Visit www.pca.state.mn.us for additional helpful information.
• • • , , • • • , • • • • • • • • -
POSTED prior to start of work - VISIBLE from street or driveway - ACCESSIBLE to the inspector
INSPECTION REQUIREMENTS:
➢ MUST schedule during office hours AT LEAST one business day prior to required inspection. If a
specific date and/or time will be required, more notice may be needed — please plan ahead. A re -
inspection fee may be charged for failure to cancel an inspection for which you are not ready, or for
failure to pass an inspection.
➢ Office Hours: Monday - Friday • 8:00 a.m. - 4:30 p.m.
➢ Phone: (952) 442-7520 or (888) 446-1801
Inspections: See your permit card to determine which of the following inspections are required for
your project. If you have any questions regarding the classification, removal, transport, or disposal of
asbestos, or any questions regarding asbestos rules, regulations, or standards, please contact the
MPCA asbestos team at (651) 296-6300 or (800) 657-3864. Information is also available at the MPCA
website: www. pca. state. mn.us.
o Pre -demo: The following items must be checked and remain in place throughout the duration of the project:
❑ Removal of all items listed in the Pre-Renovation/Demolition Environmental Checklist (attached)
❑ Traffic control ❑ Pedestrian protection ❑ Silt fence ❑ Dust control ❑ Utilities disconnected
Owner/contractor must provide verification of proper clean-up and disposal of contaminated soils,
and all abatement issues, and disconnects (see permit packet for requested documents).
o Empty hole: After the structure has been removed, the "empty hole" is inspected to verify removal
of all construction materials.
o Final: After the demolition is complete, the following items are checked:
❑ Site is properly cleaned up and appropriately graded. ❑ Street is clean
❑ Vegetation is restored, soil is stabilized, or sediment/erosion control measures are still in place.
Demolition (Structures) Page 1 of 9 Revised Mar-2020
EMSL Analytical, Inc.
3410 Winnetka Avenue North New Hope, MN 55427
TeUFax: (763) 449-4922 / (763) 449-4924
http://www,EFdSL.com , minneapollslab@emsl.com
Attention: Brad Olsson
LTT Services, Inc.
6009 78th Avenue North
Brooklyn Park, MN 55443
Project: 3832 Northern Ave
EMSL Order: 352409031
Customer ID: TWEL62
Customer PO:
Project ID:
Phone:
(763) 566-6900
Fax:
(763) 566-6903
Received Date:
09/24/2024 9:20 AM
Analysis Date:
09/30/2024
Collected Date:
09/24/2024
Test Report: Asbestos Analysis of Bulk Materials via AHERA Method 40CFR 763 Subpart E
Appendix E supplemented with EPA 600IR-931116 using Polarized Light Microscopy
Non -Asbestos Asbesto
Sample _Description Appearance % Fibrous % Non -Fibrous % Type
1
Popcorn Texture
White
100% Non -fibrous (Other)
None Detected
Non -Fibrous
352409031-0001
Homogeneous
2
Popcorn Texture
White
100% Non -fibrous (Other)
None Detected
Non -Fibrous
352409031-0002
Homogeneous
3
Popcorn Texture
_
White
100% Non -fibrous (Other)
None Detected -
Non -Fibrous
352409631-"3
Homogeneous
4
Window Glaze
Grayrran/White
100% Non -fibrous (Other)
None Detected
House
Non -Fibrous
352409031-0004
Homogeneous
5
Buffalo Board
BrowrVGray 90% Cellulose
10% Non -fibrous (Other)
None Detected
Garage
Fibrous
352409031-0005
Homogeneous
6
Window Glaze
GraylWhite
100% Non -fibrous (Other)
None Detected
House #2
Non -Fibrous
352409031-OOM
Homogeneous
7
Sink House #2
Black
95% Non -fibrous (Ot)er)
5% Chrysotile
Non -Fibrous
352409031-007
Homogeneous
Analysts)
Michael Craigmile (7)
f'o_ h—
P A,_�
Rachel Travis, Laboratory Manager
or Other Approved Signatory
EMSL melntains I3aifly limited to cost of analysis. Interpretation and use of test results are the responsibility, of the client This report relates only to the samples reported above, and may not be
reproduced, except In full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or anelytical method;imitations. The report reftect , the samples as received.
Results are generated from the fold sampling data (sampling volumes and areas, locations, etc.) provided by the client on the Chain of Custody. Samples are within quality control criteria and met
method specifications unless otherwise noted. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 604/M4-82-020'Inlerim Method")
but augmented with procedures outlined in the 1993 (-finer) version of the method. ThLs report must not be used by the client to clalm product certification, approval, or endorsement by NVLAP, NIST
or any agency of the federal government Nor -friable organically bound materials present a problem matrtx and therefore EMSL recommends gravlmetric reduction prior to analysis. Unless requested
by the client, building materials manufactured with multiple layers (i.e. linoleum, welmeard, etc.) are reported as a single sample. Estimation of uncertainty is available on request.
Samples analyzed by EMSL Analytcal, Inc. New Hope, MN NVLAP Lab Code 201 Colorado AL-24478
Initial report from: 10/01/2024 09:25:22
ASB_PLM_0009-0002 - 2.31 Printed: 10/1 /2024 8:25 AM Page 1 of 1
Minnesota Pollution Notification of Intent to
Control Agency
520 Lafayette Road North Perform a Demolition
St. Paul, MN 55155-4194
Asbestos Program
Doc Type: Asbestos & DemoljUwVAmendments
Type of notification: W Original ❑ Amended ❑ Project cancellation
Notification must be postmarked or received ten (10) working days before demolition begins. See Item S for emergency
demolitions, Both start and end dates should be amended In writing aS necessary to reflect current project dates.
Demolition Contractor
Name:
4 t_ C
Address:
blot%Lt uT ST• u:f S T- S r
Qp�jL tnN
SS1I
City, State, Zip:
_�� L,; „• PnuL t�N SSiI�i
Phone number:-
j l - �S _ t 7 Co
Contact name:
C ky, L
Phone number:
t,4. I - Sl S 6
Building Owner
Building Information
Building name: _Cr.tj,1;;jC
AddressfLocation: 8 7 0 C s-n t,•J t,t
fLIN' 2 kXVC t-lrz� .55 3 F 4
City, Slate, Zip: �; P R i rJ � p u v_;4_ j�,; r_� 53 3
County:
Phone number.
Age of bldg (yrs): Size of bldg (sq R):
Number of floors, including basement level(s):
Present use of bidg:
Name: C usG� P tL1S� lr LG _ Prior use of bldg:
�AtiZdd�r-el.s�s
CitY, State,
.1;fit [e"AfASo` LtjTUr N_ pMy J�L S
554 31 Dates of demolition or Intentional burning:
Phone number. (,51 - r7IJ,Q26r1�1 Start date: �1�05�1 y End date: ' I I o
Contact name: tvp.tLLOS mn✓dd/yy mdVddhy
Phone number: 051 i j `
Note: If there is >260 linear feet or >160 square feet of Regulated Asbestos -Containing Matenal (RACM) in the building to be
demolished, it must be removed by a licensed asbestos contractor prior to demolition. The State of MN-Not7oe of Intent to
Perform an Asbestos Abatement Project http /lwww oca.state mn.us/public-afionsAv-sw4-06.doc must be used to notify for
the asbestos removal.
Is nonfriable ACM present In the structure to be demolished? ❑ Yes �l No
Wit nonfriable ACM be present In the structure at the time of demolition? (-]yes P No
If Yes to both questions above, complete Items 1-9. If No to either question, complete Items 3-9
1. If ACM will be left In place for the demolition Indicate the amount of Category I and/or Category II nonfriable ACM left
In place.
Category I: Linear feet
_ Square feet
Cubic feet
Category I nonfriable ACM means asbestos -containing
pachings, gaskets, resilient floor covering, and asphalt
roofing products containing more than one percent
asbestos.
Category I nonfriable ACM is not allowed to remain
in place for demolition if it is In poor condition.
Category II: [_ Linear feet
Square feet
Cubic feet
Category 11 nonfriable ACM means any material, excluding
Category I nonfriable ACM, containing more than one
percent Asbestos that, when dry, cannot be crumbled,
pulverized, or reduced to a powder by hand pressure_
Category 11 nonfriable ACM is not allowed to remain in
place for demolition if it has a high probability of becoming
crumbled, pulverized, or reduced to a powder during
demolition, transport, or disposal (e.g„ transite, cement,
slate roofing).
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 TTY 651.282-5332 or gW-657-3864 • Available to altemative formats
w-sw4-21 • 12127112
Pepe 1 of 2
2. Description and location of ACM remaining in place (Including number of floors and rooms):
3. Company and/or individual that conducted the building inspection and the procedure used to determine the presence
or absence of ACM (including analytic method): (Note: Prior to demolition all structures must be inspected by a licensed
asbestos inspector who has been certified through the Minnesota Department of Health.)
1-1S1-- ANPI(b.l, Iri!
4. Description of planned demolition and the specific method(s) that will be used:
S. if the demolition was ordered by a government agency, please Identify the agency and attach a copy of the order:
Name:
Authority:
Title:
Date of order (mm/ddtyy): Start date (mm/ddlyy)
Notification for an emergency demolition must be submitted as early as possible before demolition begins, but not later than
the following working day. A demolition is considered an emergency only when the facility has been deemed structurally
unsound and in danger of imminent collapse. If the structurally unsound building is known to contain any regulated A CM or is
suspected to contain any regulated ACM, special procedures must be followed. If you are unaware of the special procedures,
instructions/ regulations can be obtained by contacting the Minnesota Pollution Control Agency (MPCA) at the address or
phone number listed below.
6. Description of procedure to be followed In the event that unexpected RACM is found or Category II nonfriable ACM
becomes crumbled, pulverized or reduced to powder.
L i00 `/ (afC6(LS) Nr -ru t"Nc ML
7. Demolition waste transporter(s) Information:
Transporter name:
Contad name
Tranporter address: -
City, State, zip:
Phone number.
8. Demolition waste disposal information: *see belowtrrmminiwnaeon
Landfill name
Owner/Operator.
Address/Location: ` --^---
Cdy, State, Zip:
Phone number:
9. l certify that the above Information Is correct and I am a bonafide representative of the demolition contractor or
building owner and have authority to enter Into agreements for my employer.
Print name: c iON�SkVCT[du t L Title: OuoNc! V_
Signature: -- — Date: i C) 0 Zq —
Important Note:
Ensure you are in compliance with Minn. R. 7036.0806 prior to the commencement of renovation/demolition.
This rule requires that the following items be removed two days prior to demolition: mixed municipal solid waste; household
hazardous waste, industrial or hazardous waste; waste tires; major appliances; items containing elemental mercury, Poly -
Chlorinated BiPhenyls (PCBs), and chlorofluorocarbons (CFCs); oil; lead; electronics; and other prohibited items. See MPCA
websHe at hhtt J1www p state.mn.us/publications/w-Sw4-20 odifor a Pre-Renovation/Demolition Environmental Checklist
Guidance Document to assist with completion of this rule.
'Demolition waste must be disposed of at a permitted solid waste facility. For other disposal option please contact the regional
MPCA solid waste compliance/enforcement staff with any questions.
Submit to: Minnesota Pollution Control Agency
Industrial Division — Asbestos Program
520 Lafayette Road North
St. Paul, MN 55155-4194
E-mail: asbestos.demolition.pca@state.mn.us
Questlons call: 651-296-6300 or 1-800-657-3864
Fax: 651-297-1438
www.pca.state.mn-us . 651-296-6300 . 800-657-3864 M 651-282.5332 or 800-657-3864 . Available in altemative formats
w-sw4.2 t• 12127112 Page 2 of 2
L9_
Asbestos (continued)
Qty
5 ra a 11ed insulation:
_Blown -in insulation:
SurtacinO materials
Acoustical plaster
Decorative aster.
Textured p2ints & coatings:
Spray-apglied materials
_ acouslical, decorative, or Insulattv_e :
Roofln
Roofs shingles:
Roofing tell:
Base flashing:
Cement materials Transits
Cement pipes flues s vents):
Cement wallboard:
Cement siding:
P board:
Ceiling materials
Ceilina titles:
Ceiling tile adhesives (pucks):
Lay -in ceiling panels:
Acoustical tiles:
Miscellaneous
Taeln�, oint and spackli
compound:
_ _
CauIwAAAnnputties_
Fire curtains and blankets:
—
_ Laboratory hoods, table
tops, Moves, etc.:
Gaskets:
ChloroFluoroCarbons
Fire extin uig shersiboth portable_
Air conditioners (rooftor
and oentraq: -_
or cold storage areas):
Water fountains and
_Heat transfer equipment:
Light ballasts:
Lead
Lead -based paint (woodwork,
metal equipment, interior/
exfedor uses):
Qty
Oty
Lead -acid batteries (lighting, exit
j
s ns recur s stems
Lead flashing molds and
roof vents:
Lead pipes and solder. _
Lead -lined X-ray rooms,
Other
Solid waste (all non -building components such as unattached
carpet files, books trash, desks,
chairs etc.) must be removed
prior to demolition:
Hazardous waste (includirql
household) must be properly
handled and disposed of prior
to demolition:
Oil used oil, h draulio oils in door
closerselevator shafts etc.
must be collected and properly
d1sposed of pdor to demolition:
Tanks no evidence of former
heating tanks or storage tanks
exist):
Appliances must berecycled
by an appliance r er.
Electronics:
If you have questions or comments about this checklist, identify any additional items not found in this fist, or would like to discuss an
individual project, contact the Minnesota Pollution Control Agency at 651-296-6300 or 1-800-657-3864.
Affiliation with project: D Qd C QNs To u Grl e rJ L U C Title: —ny_: r.) c t;
Printed name: Date: i !h - -3O_- z � _
Important Note:
This guidance document is not intended as a substitute for reading Minnesota Rules and Statutes and making
your own independent determination of their applicability to your renovatloni'demolition project. Examples in
this guidance document do not represent an exhaustive listing of type of materials that may be required to be
removed from a building prior to renovation/demolition.
www-pca.state.mn.us • 651-296-6300 • 800-657.3864 TIY 651-282-5332 or 800-657-3864 • Available in alternative formats
w-sw4.20 • 7I r6104
Pope 2 of 2
Minnesota Pollution Pre-Renovation/Demolition
Control Agency
520 Lafayette Road North Environmentat Checklist
5t. Paul, MN 55155-4194
Asbestos Program
Doc Type: Compliance/Enforcement Correspondence
Minn. R. 7035.0805 requires that you remove the items below before starting,a renovation or demolition project,
and then manage and recycle or dispose of them correctly. This checklist is provided to help you manage the
project and does not need to be submitted to the Minnesota Pollution Control Agency unless requested.
Project Information
Structure owner Structure information
Name: NV, f N i�ti� �1S_� LLC_ Building name: fLc+ S.0cI'JTiat %A0USC
Address: urn o uoh f"Q r. S Address/Location: ' iq-2i !DL 1'J 1 F"N 1 l Q:s t.d c-
City, State, Zip: CiLL O e mll3 rUN I-AIJ :5�5 43 I City, State, Zip: cPlct (, ?I -we na N s 3 ri 4
Contact name: C ktLLaS Cb¢-c a Age of bldg (yrs): Size of bldg (sq ft):
Phone number. &5 i,- ! S. -5G $��_ Present use of bldg:
Demolition contractor
Name: l- 006
Address
City, State, zip: w =Y 's s 9PuL_S S t i ii
Contact name: CCitT es
Phone number: S-$ i S SL 8 3
Battertas
_Smoke
y Emer enc li htin systems:
_
Elevator control Panels:
v EXit signs:
_
Security systems and alarms:
_
Lighting
Fluorescent _Ii ht9 s:
—WigWintinalty discharge
^_Metal halide_:,-
High pressure sodium:
Nlercu va or:
Neon:
_
Switches for lighting using _�
mercu relays lookfor any
__.
__ _ cbnhnf assodafed wilh exfenor . __
or aulumaled fiehfing s slem :
_ __
'Silent"wall switches:
Heating,ventilating, and
air conditioning systems
Thermostats:
--Aquastats:
Pressurestats:
Prior use of bldg: _
Dates of renovation, demolition, or fire training burn:
Start date: t i- S _-2-4- End date: 1 t- a- z t
(mm/ddW) (rnWdd*y)
Manometers: _
Thermometers:
Boilers, fumaces, heate
Mercury`tlame sensors by
Float or level controls:
Space heater_ controls:
Electrical systems
... Load meters & supply
Micro refs;
Boiler rooms I
equipment:
I
_ _Boiler insulation: _
T — HVAC duct insulation:
Ductwork flexible fabric
connections:
{-
Fireproofing materials:
Fire doors:
Flooring:
Vinyl floor tile:
_ Vnyl sheet flooring:
III
As halt tile:
-
Linoleum pacer b_ acicinq�
��
Mastic(glue floor tile, carpet etc.
Electrical
Electrical panels;
_ Electrical wiring insulation:
Heating and electrical
ductstconduit:
Pipe and other insulation
Aircell (corrugated cardboard):
Millboard:
Preform:
www.pca.state.mn.us • 651-296.6300 . 800-657-3864 TTY 651.282-5332 or 800.657-3864 • Available in alternative formats
w-sw4.20 • 7116109 Page I of 2
For more into rmation on PCBs In caulking or paints, see MPCA hazardous waste fact sheet #w-hw4-48k,
Mananina Sealants and Coatings Containing PCBs, at
httP://www.pca.state.mn.usipublications/w-hw4-48k.pdf,
Timeframes for removal
Remove all the wastes above and any other wastes which would be required to be removed at least two
days before the intended renovation or demolition date.
However, if due to accidental or emergency circumstances that were beyond the control of the
structure owner it is unsafe or unfeasible to remove all of these wastes prior to the renovation or
demolition work, then you may complete the work, but must identify and remove all of these wastes
from the debris prior to disposal. Note that identifying and removing hazardous and problem wastes
from debris is frequently much more difficult and expensive than removing them before demolition.
Examples of accidental or emergency circumstances when this deferral could be allowed may include:
• declaration by a govemment entity that the structure is unsafe to enter;
• damage or partial destruction of the structure by accidental fire;
• discovery after demolition or renovation has already started of previously unknown hazardous or
problem wastes which could not reasonably have been identified beforehand.
More information
Guidance and requirements in this fact sheet were compiled from Minn. R. Chapters 7035 and 7045, and
incorporate regulatory Interpretation decisions made by the MPCA on July 3, 2013. Visit the Office of the
Revisor of Statutes at https://www_revisor.mn.Qov/pubs to review the Minnesota Rules directly.
The MPCA has staff available to answer your waste management questions. For more Information,
contact your nearest MPCA solid waste staff. For information about waste and toxicity reduction,
contact the Minnesota Technical Assistance Program (MnTAP).
Minnesota Pollution Control Agency
Toll ire (all offices) ........... 1-800-657-3864
Brainerd.................................218-828-2492
Detroit Lakes..........................218-847-1519
Duluth .................................... 218-723-4660
Mankato................................507-389-5977
Marshall .................................507-537-7146
Rochester...............................507-285-7343
St. Paul...................................651-296-6300
Willmar..................................320-214-3786
Website ......... h_ttp://www.pca.state.mn.us
Small Business Environmental Assistance
Toll free..............................1-800-657-3938
Metro ..................................... 651-28 2-6143
Website http://www.pca.state.mn.us/sbeap/
Page 3 of 3
Minnesota Technical Assistance Program
Toll free...................................1-800-247-0015
Metro ......................................... 612-624-1300
Website.............. htt ://www.mnta .umn.edu
Minnesota Department of Natural Resources
Toll free...................................1-888-646-6367
Metro.........................................651-296-6157
Website.............http://www.dnr.state.mn.us/
Minnesota Department of Health
Toll free...................................1-888-345-0823
Metro ......................................... 651-201-4620
Website........ http://www.health.state.mn.us/
December2013 I w-sw4-07
Common wastes that must be removed before demolition
Type of waste
More information
Appliances; such as air conditioners and furnaces.
See MPCA hazardous waste fact sheet #w-hw3-02,
Recycling Appliances, at
htip://www.pca.state.mn.tis/publications/w-hvv3-02.pdf.
Asbestos; such as pipe lagging and furnace flues.
See MPCA webpage 1482,
'ltany asbestos-costalningmaterlal(ACM)isleft lnpiaceln
Asbe,Lto5Program, at
the portion otstructure to be demolished, then all resulting
http://www.pea.state.mn.us/tchy7f7.
debris must be managed and disposed as ACM.
See MPCA hazardous waste fact sheet #w-hw4-15,
Electronics; such as smoke alarms and home
entertainment systems.
Managing Electronic Wastes, at
http://www.pGa.state.mn.us/publlcations/w-hw4-15.pdf.
Environmental and safety system controls; such as
See MPCA hazardous waste fact sheet #w-hw4-62,
thermostats and manometers.
Managing Universal Wages, at
htti)://www.Rca.state.mn.us/publicatlons/w-hw4-62.odf.
See MPCA hazardous waste fact sheet #w-hw3-12,
Hazardous waste; such as lawn chemicals and paints.
Managing Waste from Residential Propertiesat
http://www.pca.state.mn.us/publications/w-hw3-12.pdf.
Lead -containing items; such as pipes and roof
See MPCA hazardous waste fact sheet #w-hw4-23,
flashing.
Lead Paint Disposal, at
'Lead paint may remain on the structure.
http://www.vca.5tate.mn.us/publications/w-hw4-23.pdf.
Lighting components; such as fluorescent/HID lamps
See MPCA hazardous waste fact sheet #w-hw4-62,
and ballasts.
Managing Universal Wastes, at
http://www.pca.state.mn.us/ppbllcatton$/w-hw4-62.pdf.
Oils; such as fuel all and hydraulic fluids.
See MPCA hazardous waste fact sheet #w-hw4-30,
Used Oil and Related Wastes, at
http:l/www.pca.state,mn,us/publications/w-hw4-30.pdl.
Refrigerants and halons; such as chillers and halon
See MPCA webpage #62,
fire extinguishing equipment.
Chlorofluorocarbons (CFCs), at
http://www.pca,state.mn.usivhiz4b8.
Solid wastes; such as furniture and window
treatments.
Submersible well pumps, which may contain
Search for MDH publication 1141-0434, 'Sealing Unused
polychlorinated bfphenyis (PCBs) or mercury.
Wells', at htto://www.health_5tate.mn.us/.
Any other wastes not acceptable at a disposal
facility; such as radioactive or Infectious wastes.
Wastes that do not need to be removed before demolition
You do not need to test paint for lead or remove suspected or known lead paint from a structure If you
are going to demolish the structure or if it will be burned for a legitimate firefighter training burn.
You also do not need to test caulking or paints for polychlorinated biphenyls (PCBs) or remove
suspected or known PCB caulking or paint It you are going to demolish the structure. It the structure will
be burned for firefighter training, however, the caulking and other sealants must be tested for PCBs and
any PCB -containing caulking removed prior to the bum.
Page 2 of 3 December 2013 w-sw4-07
OrderID: 352409031
EUML ANALYMAd. MG.
Asbestos Chain of Custody
EMSL Order Number (Lab use Only):
1 3 I
14375 2;1'' AVENUE
MINNEAPOLIS. MN 55447
PHONES (7631449-4922
FAX: (763)449-4924
Corn : LTT Semi Inc.
EINSL-MlI to: 0 Same ❑ Different
If BE to Is Diderent rote Ir4bv tkxn Ir Commenft-
Third Party Sft requaws wrdten autA=abw from third
Street: PO BOX 43503
Brooklyn Park
State/Province: MN
ZIPToetal Code: 55W Country: USA
Report To (Name): Brad Olsson Fax M 763.686-6903
Tel #-. 76336lt~8900 Email Address: brad0twellenv.corn
Project Name/Number. 3832 Northern Ave
Please Provide Results; Fax Email Purchase Order U.S. State Sam Taken: MN
Turnaround Time A . - Phn" Check
3 Hours 0 8 Hours 24 Hm 48 Hm I El 3 Days 4 Days 5 s 10 Lms
'For TEM kr 3 hoursr5 hours, piseee cad ahead to adwdrde 'There is a premmn charge for 3 Harr TEM ANERA or EPA LwAIJ TAT. You wrN be asked to sign
an aufhamahon brM for this aerme. An in accordance with EUSL s Terms and Ca mMons bceted in i Pace Guide
PCM—M - Al
[I NIOSH 7400
❑ w/ OSHA 8hr. TWA
- Alr
❑ AHERA 40 CFR, Part 763
❑ NIOSH 7402
❑ EPA Level If
❑ ISO 10312
TFJA-
❑ Micxovac - ASTM D 5755
❑ Wipe - ASTM D6480
❑ Carpet Sanicatkm (EPA BOQ/J-93)167)
P - i
® PLM EPA B00/R-93/116 (<1%)
❑ PLM EPA NOB (<1 %)
Point Count
El400 (<0.25%) ❑ 1000 (<O.I%)
Point Count wlGravimeMc
❑ 400 (<O.25%) ❑ 1000 (<0.1 %)
❑ NYS 198.1 (friable in NY)
❑ NYS 198.6 NOB (non -friable -NY)
NIOSH 9W2 <1 %
WI Rocki myicutite
❑ PLM CARB 435 - A (025% sensitivity)
El PLM CARE 435 - B (0.1 % sensitivity)
❑ TEM CARB 435 - B (0.1% sensitivity)
❑ TEM CARB 435 - C (0.p1 % sensitivity)
❑ EPA Protocol (Semi -Quantitative)
❑ EPA Protocol (Quantitative)
TAM___- Bulk
❑ TEM EPA NO
❑ NYS NOB 198.4 (ton -friable -NY)
❑ Chatfield SOP
❑ TEM Mass Analysis -EPA 600 sec. 2.5
IEM-1Nater: EPA 100.2
Fibers >10Nm ❑ Waste ❑ Drinking
Ali Fdw Sizes ❑ Waste ❑ Drinking
Other
Check For PosWve Stop - Cieaq Identify HomogenabsGroup
Samplers Name: Brad Mason
Samplers Signature:
Sample d
Sam DescH
Vdua(Air)
HA Bulk
DateTme
isampled
1
-+-
L' 4L�1 a t'Ir
i
2
3
4
W i AlP.;, 6I ALA, ��Sk
5
r, ��, 6fitA
6
1
7
L
8
Client Sam (a): - Total ;8 of Sam
Relinquished (Cllent : paw; Time:
Received (Lab): Date; C\ Time:
Corms ovarr.n-nscaI.. me - R1 -an Waft
MW
Paqe 1 Of 1
CITY OF SPRING PARK
PAGE 1
BUILDING PERMIT
4349 Warren Avenue
Spring Perk, MN 55384
El Handout Given
Phone: 952-471-9051 Fax: 952-471-9160
El Lead Handout Given
e o ted to SP T
r,
SITE ADDRESS:_3_�
PtD:
1) Was the home constructea oefom 1918? (YES L7, conlhiue with line
21 MO ci continue without completing EPA Section)
2) 'J'dill the work disturb �:b sq tt of intevior painted surfaces or z20 sq ft of exterior ;painted surfaces? (YES ❑ go to line 4, NO ❑ line 3)
:l) Are there any windows being replaced? (Y-ES o, go to line 4;. NO
❑ continue without completing EPA Section)
4) Has this home been Certified Lead Free? (YES ❑, you MUST Attach Ce f.ification information, NO ❑ complete line 5)
EPA Contractor C ertification Number: NAT -
(applies to contractor only)
•
FeROP€R'�YOVMER P. S- LLL
Address: tiL —
Oty State: i'SP Zip, 15 5 LiI
Email:
�•
Contact Name: 9, we ®w I
Phone' ! w r q4l� Q
(:ONTRACTOR:
Address:
Am: State: N/V Zip:
Phone: o Fax:
(:ontractor Lkense No:
Contact Dame: V Phone. r�
gg
Finak: N/�nt°i�/rx�, 4tyrz.7�
/tRCHITECT:
Address:
G : State: Zip:
Phone: Fax:
•
E:rrlail:
Contact Name: Phone:
TYPE OF WORK: ❑ New Construction
C. neck - Pool : Re -Roof
Commercial C Residential u Change of Jse
= Retaining Wall C Porch ❑ Re -Sine
EST. VALUATION OF WORK ^ Finish Basement
;q Demolrbon ,71 Fence
f 5, DBa C Remodel
_
, Fire Sprinkler Shed
`ipuare feet ❑ Addition
FireAlarm Window/Door Replacement
- Garage-Attached/Detach
❑ Plumbing-orc-Ade 49W cn Pape: # being replaced
Detailed Description of Work: Accesso Structure
Mechanical-Providedersfl on =age 2 idiisc Other
bnawre of this aWcation In the isgal property ownw or s lcertsed ca&scux, as the owners wresentaff". Is relined and authortnes the ZoNng Admf bztor or designee and the 6uXWli Oftkial
'a dea" to enter upon the property to parwm needed Inspsctbns. Entry mev be klthoul prm
notice. I hefty acknowW4* final I have reed IMs applcaticn and state that all Information Is true end
rmect la the best of my kmwfedgw I further agree that at work perhxmed M be in accordance •with approved plans. apsclllmdone and eonditlonr and to abide by al onwanees of the mwu c pally
4hd the km of the State of M.kmaota regarding wilors talon pursuant to this permfl. I ague to
pay sit p$ n rew" Pew wen If i choose not to proceed with 1he work. Pesnh evints when wait
rr
s not commenced within 180 days horn dale of pwnk or y was Is suependW, abandonw, or not Inspected tor'80 days. work beyond the scope of this per nIt, or work whnart a p•rmt or Inapecllm.
•
11 be surfed to a penally.
Nolw Ordinance In Effect MONDAY - F RIDAY Before 7 a.m.
nd after 111 pm. WeekendefHolidays before 7 a.m, and after 8 p.m.
SIGNATURE OF APPLICANT: �.
, ;. DATE: I
PRINTED NAME: r � .+' . ,`,
This is the signature of: c Owner or u Owners Representative
OCCUP. TYPE: d6NST. TYPE: CODE:
BLDG SPRINKLED Yes / No
VALUATION: $
Permit Fee: $ 551e40YJ
WAG Charge: $
Plan Review Fee: $ § 1
Sewer & Water Hook -Up: $
State Surcharge: $ '�
Sewer 8 Water Disconnect $
Site Inspection Fee: $
Water Meter. $
S.E.C_ Fee: $
Muni SEIWA Fee: $
investigation Fee i Other Fee: $
*2016 SAC Escrow. 32-4i5
}
Copy Charge ($.25 per 8.5 x11 page) $
Other. $ f
Z
Liconco Chock ($5)1 Load Chock ($6) $
TOTAL DUE, $ *
O
W
SUBTOITAL $ �.
Plumbing F$
gee (from Page 2 )
Commercial plans will be submitted to the Met Council EnAronm ntal Svcs
for SAC determination. Escrow payment will be required when permit Is issued. If
V
Mechanical Fee from Pa e 2 $
after Met Council review no SAC Is determined, escrow will be refunded In full.
LL
Special Condition siRequired Setbacks:
O
Building Approval By:
DATE:
Printed Building Approval By:
❑ License Verification ❑ Lead Verification - Checked By:
City Approval By:
DATE: i a
Pale a0 Date: l �5
a Receipt No.
By
CITY OF SPRING PARK ❑ MECHANICAL PERMIT
❑ PLUMBING PERMIT
PAGE 2 FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
MECHANICAL INFORMATION
Mechanical Contractor: Address:
City: State: Zi : Phone: Fax:
State Bond No:
Contact Name:
Email:
Contact Phone:
Detailed Descrkdion of Work:
Indicate type of project, fixtures, and Gas Lines you will be installing
MECHANICAL FIXTURES
or replacing (include count for each type of fixture):
GAS LINES
Quantity Quantity
QuaMity
Furnace _ Kitchen Fan
Furnace
Air Conditioning System Bath Fan
Fireplace
Air Exchanger Grill
Unit Heater
Fireplace
Water Heater
Unit Heater -
Grill
I n Floor Heat
Dryer
Gas Log
Stove
Office Use Only,
❑ Replacement (one fixture only, no piping or vent changes)
Mechanical Permit Fee: $
❑ AdditiontRemodel
Gas Line Permit Fee: $
❑ New Construction
State Surcharge: $
❑ Other
Other $
Total Mechanical Permit: 5
PLUMBING INFORMATION
Plumbing Contractor:
Address:
CState: zip, Phone: Fax:
Plumbers License No:
State Bond No:
Contact Name:
lContact Phone:
Email:
Detailed Desc of Work:
Indicate type of project and fixtures you will be installing or replacing (include count for each type of fixture):
PLUMBING F&TURES
L QuantityL
Water Heater - _ Shower Laundry Tub
❑ Gas ❑ Electric Dishwasher Roughen Future Fixture
Water Softener Clothes Washer Sump
Lawn Sprinkler System Ice Maker Line Water Piping System
Water Closet (Toilet) Hose Bib Floor Drain
Lavatory Wash Basin Bathtub
Office Use Only:
❑ Replacement (one fixture only, no piping or vent changes)
Plumbing Permit Fee: $
❑ Addition/Remodel
State Surcharge $
❑ New Construction
Other. $
❑ Other
Total Plumbing Permit: $
City c f Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952) 471-9051
24SP-00127 I Demolition (Residential)
Payment Amount: $562.36
SPRING PAR
On LakS Winnetonkg
Receipt Number. 400
November 26, 2024
Transaction Method Payer
Cashier
Reference Number
Cash Edde Construction
Jamie Hoffman
Comments
Contractor paid Finance Clerk $563.00 at City Hall.
Assessed Fee Items
Fee items being paid by this payment
Assessed Fee Item
On
Account Code
Assessed Amount Paid
Balance Due
11/25/24 Lead Certification Look -up
$5.00 $5.00
$0.00
11/25/24 State Surcharge
$7.50 $7.50
$0.00
11/25/24 Residential Demolition Plan Review
$216.61 $216.61
$0.00
11/25/24 Residential Demolition Permit
$333.25 $333.25
$0.00
Totals, •
$562.36 $562.36
Previous Payments
$0.00
Remaining Balance Due
$0.00
Application Info
Property Address Property Owner Property Owner Address Valuatlon
3832 NORTHERN AVENUE AK ENTERPRISE LLC / Anan 9601 HUMBOLDT AVE S $15,000.00
SPRING PARK, MN 55394 Barbakawi BLOOMINGTON, MN 55431
Description of Work
Demo