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Permits - Permit# SP-2021-00070 - 3822 Northern Avenue - 7/14/2021
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P rk I 1\1 (J-11"I'A RIK To Schedule an Inspection Call: 952-442-7520 Details City of Spring Park Permit Permit Number: SP-2021-00070 Issue Date: 7/14/2021 Zoning Type: RESIDENTIAL Use Type: IRCA, IRC-1 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS • MON-FRI: 8AM-4:30PM • NO HOLIDAYS Site Address: 3822 NORTHERN AVENUE, SP, MN 55384 Description: DEMO -HOUSE & DETACHED GARAGE Permit Granted To: OLSONS SEWER SERVICE INC Homeowners Name: AK Enterprises LLC Phone Number: 651-890-9694 Parcel #: 1711723330137 Permit Type: BLDG - Demolition Permit Exp: 1/9/2022 Valuation: $9,276.25 Fees Receipt•• Date Quantity Date Paid Status Pmt Info Amount 13042 —Permit Fee 7/13/2021 1.00 7/14/2021 Paid Visa: ****= ** -****6225 $244.50 13042 State Surcharge 7/13/2021 1.00 7/14/2021 Paid Visa: ****-****-****6225 $4.64 13042 Plan Review Fee 7/13/2021 1.00 7/14/2021 Paid Visa: ****-****-****6225 $158.93 Total: $408.07 Notes • This permit is issued in accordance with and subject to all provisions of Ordinances and policies governing building and zoning in City of Spring Park. • Permit Holder/Contractor/Owners Agent is responsible to call for the inspections! • Permit Packet, including approved plan, and this inspection record must be posted in an accessible location before calling for inspection. Maintain this inspection record until work is complete. • No deviations from the approved plans are allowed without prior consent from the building inspections department. • To Owner, Occupant, or Contractor: It is ILLEGAL TO OCCUPY this area/building until all required final inspections have been made, approved, signed, and certificate of occupancy issued! Scott Qualle, Building Official City of Spring Park #4349 Warren Avenue ♦ 55384 Copyright ©2021 INSPECTION RECORD 2020 MN State Building Code CitV of SDrina Park Permit Number: SP-2021-00070 Issue Date: 7/14/2021 SITE ADDRESS: 3822 NORTHERN AVENUE, SP, MN SS384 uesrnoaon. PERMIT TYPE: BLDG - Demolition DEMO -HOUSE & DETACHED GARAGE ZONE/USE TYPE: RESIDENTIAL IRC-4, IRC-1 APPLICANT: OLSONS SEWER SERVICE INC OWNER: AK Enterprises LLC No inspection will be performed, and a re -inspection fee will be charged, if this "Inspection Record", the "City of Spring Park Permit", and, when applicable, the approved plans are not available to the inspector. This permit expires if construction activity does not commence within 180 days from obtaining this permit; when construction activity has been suspended or abandoned for at least 180 days; or the work has not been inspected within 180 days from the last documented activity. IF SEPARATE PERMITS ARE REQUIRED, REFER TO THE "SEPARATE PERMITS REQUIRED FOR:" STAMP ON YOUR APPROVED PLANS/CONSTRUCTION DOCUMENTS TO IDENTIFY WHAT SEPARATE PERMITS ARE REQUIRED. ALL REQUIRED ROUGH -IN INSPECTIONS, NOTED ON SEPARATE PERMITS, MUST BE COMPLETED PRIOR TO SCHEDULING A FRAMING INSPECTION. ALL REQUIRED FINAL INSPECTIONS, NOTED ON SEPARATE PERMITS, MUST BE COMPLETED PRIOR TO SCHEDULING A BUILDING FINAL INSPECTION. DO NOT COVER ITEMS TO BE INSPECTED. Permit Card (4) Inspection Inspectors Response Approval Date Comments or Corrections Required Disposal Manifest Required Empty Hole Required Pre -Demo Required Demolition Final Required MUST CALL TO SCHEDULE NO LATER THAN THE BUSINESS DAY PRIOR TO THE INSPECTION DAY: 8:00 A.M. TO 4:30 P.M. MONDAY THRU FRIDAY. PHONE NUMBER TO CALL: 952-442-7520 When a Certificate of Occupancy is needed, return this card and the approved final inspection notice to the City of Spring Park office. CITY OF SPRING PARK PAGE 1 BUILDING PERMIT 4349 Warren Avenue SP-2021-00070 Spring Park, MN 55384 ❑ Handout Given Phone: 962-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given Routed to MNSPECT SITE ADDRESS: Ma ak 440'.PID:_ / (110,001,17 1) Was the home constructed before 1978? (YES Ircontinue with line 2, NO o continue without completing EPA Section) 2) Will the work disturb 2:6 sq ft of interior painted surfaces or 2!20 sq ft of exterior painted surfaces? (YES Vo o to line 4, NO n line 3) 3) Are there any windows being replaced? (YES o, go to line 4, NO/continue without completing EPA section) ) Has this home been Certified Lead Free? (YES u, you MUST Attach Certification Information, NO tr'complete line 5) 3) EPA Contractor Certification Number. NAT • (applies to contractor only) • PROPERTY OWNER: A ay!► Jltli. State: fA it o: Email: Contact Name: Phone: • CONTRACTOR: Sirwr-i- Address: to :� Phone: I- Fax: Contractor License No: Contact Name:Tktftk)t_cn"',ne�AAW901 Emal: tark A� ARCHITECT: Address: State: zip: Phone: Fez: Email: Contact Name. _� �...�h ` nne: <" TYPE OF WORK: ,,r o New Construction ❑ Deck a Pool o Re -Roof o Commercial t esidential EST. VALUATION ❑ Change of Use a to W Porch ra Reside OF WORK o Finish Basement 1 o Fence $ nt03.a"l ��� c Remodel � a Fi r ❑Shed x Square feet c Addition =� ❑ ®Alarm ' ❑ Window/Door Replacement a Garage-Attached/D tlPlumbing-provide detal on Page 2 # being replaced R Detailed Description of Work: C AccesSo " 'Skcturep MBChaniCa) provide detail on page 2 ❑ Misc Other • r. Signature of this application by the legal property ovmar arts ecanew contractor, as the menses representative, is required and authorizes the Zonis Administrator or g desigwe and #w Building IXAckl or designee to order upon the property to perform deeded Insiosctions, Entry may be Iiphout prior notice_ I hereby adonwladga that I have reed this appocatlm and state that all 1*nnatbn Is true and correct to the best of my knowledge. I turther agree that al work pedomad,VA tie 6 ac cordance with approved plans, specska#ora and condkbns and to abide by al ordinances of Ow Municipality rs end the laws of the State of Minnesota regard% actlons taken purevent to thin permft. I agree to pay all pum rwAow fees even If i choose not so proceed with the work. Pernib expires when work is not commenced wtthh 180 days tiom dots o/parmlt. ar`#wafk tsnuspended, abandoned, or not inspected for 180 days. Work beyond the scope of this pennb, or work without a pwMk ar Inspectlan, • wul be subject to a penalty. Noise Ordinance In,Effe ' ^• ONDAY - FRIDAY Before 7 a.m. and after 10 pm. Weekands/Holidays before 7 a.m, and after 8 p.m. SIGNATURE OF APP ICE R DATE: -° ,�i -Z .' D PRINTE' This is the signature of: u Owner or t6wnees Representative OCCUP. TYPE: CONST. TYPE: CODE: BLDG SPRINKLED Yes / No VALUATION:$- 9,276.25 Permit Fee: $ — _ 244.50 WAC Charge: $ Plan Review Fee: $ 158.93 Sewer & Water Hook -Up: $ State Surcharge: $ 4.64 Sewer & Water Disconnect: $ Site Inspection Fee: $ Water Meter. $ S.E.C. Fee: $ Muni SE/WA Fee: $ Investigation Fee / Other Fee: $ *2016 SAC Escrow: $2,48 i >; Copy Charge ($.25 per 8.5 x11 page) $ Other. $ z Liconco Chock ($5) / Load Chock ($5) $ TOTAL DUE: $ w SUB -TOTAL $ 408.07 rn NCiTE. Commercial plans will be submitted to the Met Council Environmental Svcs Plumbing Fee (from Page 2) $ lu U for SAC determination. Escrow payment will he required when perm R is issued. If Mechanical Fee from Page 2 $ after Met Council review no SAC is determined, escrow will be refunded in furl. u. Special Conditions/Required Setbacks: O Building Approval B : DATE: 7/12/2021 Printed Building Approval y:Kpxti I n KqmPrijri0 License Verification O Lead Verification - Checked By. City Approval By: , DATE: Paid: A ; Date: / -/_� Receipt No..y3/ j s/17 JJw By I Read all attached materials. Everyone performing work to which the code is applicable shall comply with the code. The field copy of these plans must be kept on -site and made available to inspector during all inspections. To schedule inspections call (952) 442-7520 Please have the permit number and street address ready at the time of the call. BEFORE YOU DIGContact Gopher State One Call to locate buried utilities.651-454-0002 or 800-252-1166www.gopherstateonecall.orgln accordance with Minnesota law, you must wait 48 hours (excluding weekends and holidays) after you've submitted your dig information to begin your digging project. Reviewed for Code Compliance This review is limited to the submitted scope of work, is based upon the supposition that the plan accurately depicts the intended construction and end -use, that the necessary legal authority has been obtained to construct the project and work is subject to code compliance and field inspection during construction. By: kkamerud Type of Construction: Demo Date: 7/12/2021 Occupancy Classification: IRC-1, IRC-4 Permit #: SP-2021-00070 Code Edition: 2020 MN Residential Code Prior to demolition, the following items must be completed and shall remain in place throughout the duration of the project: o Sewer and water lines to be disconnected. o Wells must be capped and abandoned. o All utilities; including gas, electrical, and telephone services; shall be disconnected. o Silt fence must be installed until vegetation is reestablished. o Documentation for proper clean up and disposal of and/or abatement of contaminated soils. M N S P E C T„ r PHONE:952-"2 7S21520 EMAIL: INFOOMNSPECT.COM • DEMOLITION (Structures) ➢ This handout is intended only as a guide. It shall not be considered a complete set of requirements. ➢ A permits is required for demolition of a building structure 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. ➢ 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 estabishe4 by the Minnesota Pollution Control Agency. The Departmerifof Natural Resourc bs, County Environmental Services Department, County or Local Watershed, Municipality Utilities and Public Works Directors are exgmples 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. Building Permit Application, completed in its entirety, including signature and valuation. Checklist for Demolition Permit (included in this handout). ❑ 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 6f this step with your Application. (Single family dwellings are generally exempt from this requirement.) POSTED prior to start of work - VISIBLE from street or driveway - ACCESSIBLE to the inspector INSPECTION REQUIREMENTS: Inspections MUST be scheduled during office hours AT LEAST one business day prior to inspection. If a specific date and time is required, additional notice may be needed. Failure to cancel a scheduled inspection may result in a reinspection fee. ,➢. Office Hours: Monday - Friday - 8:00 a.m. - 4:30 p.m. ➢ Phone: (952) 442-7520 or (888) 446-1801 , Insaections: (Refer to your permit card regarding project -specific inspections. 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 ❑ Sift fence ❑ Dust control ❑ Utilities disconnected ❑ Owner/contractor must provide verification of proper dean -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 sedimentlerosion control measures are still in place. Demolition (Structures) Handout Page 1 of 9 Copyright 0 MNSPECT 2020, Rev. Nov 2020 Checklist for Demolition Permit MUST \\be included when applying for permit) Project Name: �,G Y��g [- C.Qi l�dSi�(�Date: "7 -La*%R Address: y%Municipality: Owner's Name:Telephone Number: i�• C Contractor's Name: S►k'i Telephone Number: �Q Detailed axnlanation of work to be oerformed: Yes No- (� Will the demolition work disturb treater than one acre of land? Disturbed land includes: land used for stockpiling; land surrounding .the structure that -is to be demolished that will be altered during the final excavating worK the land where the removed structure was located; construction site entrance. IF YES: Separate Stormwater Pollution Prevention Plan.41 PCA) and local MS4 requirements may apply. IF NO: Sediment and erosion control practices must be maintained. Have the following been "submitted.or completed? Ye No NIA ❑ ❑ Completed permit application. ❑ ❑ g Two sets of site plans verifying the location and size of structure(s) being demolished. ❑ ❑ [Z Two sets of plans showing area of interior/exterior demo work. ❑ J A written description of building demolition method. ❑ ❑ A written verification and/orsite plan identifying the type of pedestrian protection being provided, including description of type, location and height of fencing to be used. ❑ ❑ Rr A performance bond, letter of credit, escrow or securities in accordance with Municipality polic El El[+� A Dey.molition/Renovation Notification submitted to the Minnesota Pollution Control Agency. (Under Section 40 of the Code of Federal Regulations Part 61(M), if the structure is regulated, you must submit a Notice of Intent to Perform a Demolition. Single family dwellings are generally exempt.) ❑ [� ❑ All utilit)es properly terminated. * � W e- lk rtroc4 'r\ctft Q.tsi Cv tiolipp ❑ ❑ m All wells'properly abandoned in accordance with State Health Department regulations. o�}�e ❑R [Z Septic tanks pumped and removed. U ❑ ❑ Are there any underground storage tanks to be removed? [� ❑ ❑ All hazardous materials removed and disposed of in accordance with Minnesota Pollution Control Agency requirements. See the MPCA documents Pre-Renovation/Demolition Environmental Checklist and Pre -Renovation or Demolition Requirements (attached) for more information. ,,' - Signed: 1' Date: ;t LR Demolition (Structures) Handout Page 2 of 9 Copyright 0 MNSPECT 2020, Rev. Nov 2020 Minnesota Pollution Pre- Renovation / Demolition - Control Agency 520Lafayette RoadWrtb Environmental Checklist SLPaul, MN 55155.4194 Asbestos Praqr� Doe Type: Ca o*mdence Minn. P. 7035.0805 requires that you remove the items below before starting a renovation or demolition project, and then manage and nwyele or dispose of them correctly. This dvaci list Is provided in help you manage the project and dose not need Robe submitted to the Minnesota Pollution Control Agency unless rsqueded. Project Information Structure owner Structure Information Name: ke! '5s& Building name: Address: 1 V 3 Le ..r �l'C.�cS s' Addres ocation: CRY, State, Zip: V^0►0%a4ODA MO SS101 City, Stare, Zip: r' Contact name: Age of Bldg (yrs): Size of bldg (aq It):' t ZAP d' r.+ Phone number♦r L&S3 Present Lne of bldg: pi,— Dematkion contractor Prior use of bldg: P Name: CCJ5Qr% b StLtA]td' SG.r'V`iGat Address: tt—► t . -A-W LAI ert t w119 CRY. State, Zip: Contact name: Phone number: Dates of renovation, demolition, or fire training burn: Stert date: End date: f+ry+rUGIYn O-eft NO rrww.pca.state.mn.us • 651 29643W • 800-657-3864 TtY 651-282-5332 or 80Q657-3864 • Avallable in alternative formats w-sw4-20 • 7116109 Page t of 2 Demolition (Structures) Handout Page 5 of 9 Copyright 0 MNSPECT 2020, Rev. Nov 2020 If you have questions or comments about this checklist, identify any additional items not found In this list, or would like to discuss an individual project, contact the Minnesota Pollution Control Agency at 651-296-6300 or 1-800-657-3864. Affillation with project: Pt-,Y O*11CC" 1*11 o e Title: 'r , *"r Coo ' ' yip'-Aoe Printed name: TcX \f.- 'y vyd- J' Date:.=7=1 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 renovationidemolition 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.pta.state.mn.us • 651-296-63W • 800-657-3864 TTY 651-282.5332 or800-657.3864 • Avattabte in alternative formats w-sw4.20 • 7116109 Pw 2 of 2 Demolition (Structures) Handout Page 6 of 9 Copyright 0 MNSPECT 2020, Rev. Nov 2020 'S- ee'- f:W c lesinc. June 10, 2021 Attn: Carlos Cones 131 Richmond St W South Saint Paul MN, 55075 Re: Asbestos Materials Survey - 3922 Northern Ave Spring Park, MN 55394 LTT Services, inc. was retained by Mr. Curios Cortes to conduct an asbestos materials survey of the above property to prepare the building for demolition. Suspect asbestos building materials were inventoried by a Minnesota Department of Health Certified Inspector. Samples were collected on June 2, 2021. The inspection services performed by Urf Services, Inc. have been conducted in accordance with industry standards and current regulatory guidelines. The services performed have been conducted using standard professional practices. No warranty or guarantee is made by the submittal of this report. We have listed the materials that will need to be removed in the attached Executive Summary. We appreciate the opportunity to provide environmental services for your project. Sincerely, Brad nlsson L T Scrvkm lo¢. 33n Nodbaa Ave Asbesn Materials Slovey 1. Executive Sumrutarry This report summarizes the findings of our asbestos materials survey. 1) Asbestos Building MatedAh The building was inspected for the p mse= of suspected asbestos containing materials. A complete list of the materials tested is listed on the next page of this report. The following definitions and acronyms are used in describing Asbestos Containing Materials. • ACM - Asbestos Containing Material. ACM is any material that contains greater than 1 % asbestos. • Friable ACM -a Any material that contains greater than I % asbestos which can be crumbled, pulverized, or reduced to powder by hand pressure. All friable materials must be removed before demolition. • Category 1-- non friable ACM - Any ACM packing, gaskets. resilient flooring, and asphalt roofing. 'These materials must be removed prior to demolition or renovation if the demolition or renovation activities might cause it to become friable. • Category lI - non friable ACM - Any ACM excluding Category 1. Thee materials must be removed prior to demolition or renovation. • Homogeneous arcs - an am of surfacing materials, thermal system insulation materials, flooring, or other miscellaneous materials which upon examination for properties such as age, color, and texture appear to be composed of the same material. Ibe following material was determined to be non -suspect ACM and was not targeted for sampling. • Fiberglass insulation • Masonry walls • Glass windows • Carpel • Wood millwork The following suspect materials were sampled at the site. • Flooring Mastic • Texture Ceilings • Lined Light Backing • VCrmiCUlitC h aWF�r NIy� EaA�ns: 10J01>btr !M l Q. 1�q ti1M M MM' r ew +Wl+[n. � a,+3ZD frrwy tY]D'Ait �" "� SOTA 1r ►�WRTN DAKOTA .LiO "ORT C"TRUCYVN 4ANORER6 EDUCAT)ON, APPRENI"SW' AND 1 A"W FUND OF MINN IA AND l )RN DAKOTA 23W Non ftad- lbo Lr . LW 55aM (66 t) 653-b710 Ttft caedifts that BRAD L OLSSON fuss sathisiftft oompleW the requeW trainwq And alft w p m aobod by Ws C:onslnudK)n l.s"mm, EducaUM Apprenticumip;uxl Training Fund of Minnesota and Nonh Dakota in Asbeews k4pww Rfbeshm 100204D 10lWIM 1TiWc6ume Wpi M m►"`RTukts Camp'kswgh TITLE WSECIOWSCA 2 OCTOBER 20 In testimony tfrered 1 tlAve afiiwed rrryr sii�ltre ihfs day _ 10=1328 •aw•' `-' 1 WAl.Vi, rC..`c.3R1x.✓4[cG -. :iliu '.)..�Ii.i�lM r • EON~ ova! bje )d i t fn EMSL Analytical, Inc. mova"w" wosmwowv%m aw WFWMW**wMlMM40-4M two im*w om ow"', ffwww*000 oft amm M sw%*w ft SM7ftAvenue North &a*o ftK MN VM3 EMtiL W MW cusWw MD: T*%eM CLVWWPO: Pro)*" 10: Phofw: (103) Fax: (Mass4m p,ocotvsd DM: ogq%=i 015 AM AmtpW Debi: 05000=1 C000cfjed Dow: ba 3MNWWn*ASMPark rW Roport Asboofts AmgWg Of && Agsftdals vie EPA GOOM40MIS Aft~ tuft fthwtW LWO UknmMWY DGWAwma Appowsm" % FMNV40 $"moo - 3FAC46AMS NwObr" (09w) 60% chvww LVM o.auno SOS~ V*ft tielroua mom-*X&A (Or-) Gh" IONS PbDr%-wm (Ow 3 W*%33. Gtw* Mon Cesymp"m ftpow, C-,,; log% Nm WC -A Ptl-) mom Descood i"Wo 5 Pop=$ C-,,-Q W,!f Nor* Detocad pw= C"" YAWJI W% PWOI*tO%A (OW-) Nor* DvqK*d TGAIM poo"lafm 16% Nwlmfo6m 4(waf) Nora Dole-W L slo*bm w Didd, &wm I GO% Non-ftmA (oww) Nor* ()04*CW Man V+jrtr,f Mutt B.sn lom mw"w%js powl N" o"Ima 2ft ce-ofto 75% horfftmus loew) NOV DehCbd vey"xm 14mw,,- LN,U.dm M Non-ftraA (00*r) N" Ds%C%d Kftrom S Fqw Nor-Fgbrays I DO% Mon 4&0,A K*w) Wart F�r;x.n NW* D"Ro" iw% wor�ftmm (Oft() Noew Dobcbd EJ�VAVVv I Tk- C*ajo" W% ftm-as {goat) P" I of 2 -OrdsrlD: 35210SO46 Asbestos Chain of Custody 143752rAVEMJE EMSL ord*r Numbtr (Lab the ww*Ap", MN 55447 0 b 4 PHow� (783)44"9U FAX' 063)440 4824 E OL430 b: 8srne OMIwrA Canperry_: LTT ietNue, Mlo^ _ ! r me d a oaArenr ror tnet+okr+M t�rens+er' Sheet SM 76e Ave N _ ___. 77,ad Pw& BMV MQOIM wftn Iorw N*d ,- ----- fie: (NN _ Code: S6NJ _, USA TeMphorw f: 70146iil00 Addnes brsddlw!Merh► eoal pmod Namej%rnber. 3W Northam Ave Bphp Park Pleasa Prov4de Results: Fax EmaN P1p'CCfu1le Order U,S State Taken: Tea nd�A - - P� Check 6 /0 Dow i UstiW—TDOHOUIS 24 Hre A Hn i 4 'Far TEE M 3 howty now: oven car ~ to xf»an ' naa a a PMO^A- dw" for J tbw My Ah49M or EPA s TA U Ybu we Os saw to aqr an *Aftrkorm tmm fx Mg "Mm A-..+ejss m acoad0uw0 �n FAiSLY TKtnO Md �"IG+�s b0ow In tl+e Prim 06"R A - Air TEM • AMTOOk D NIOSH 74D0 ❑ AHERA 40 CFR, Pal M ❑ Maaovsc - ASTM D s755 ❑ 0OSM ft. 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ENVIRONMENTAL & CONSTRUCTION SERVICES June 17, 2021 To whom it may concern: Re: Asbestos Abatement — 3822 Northern Ave Spring Park; MN Twell Environmental, Inc. has completed the asbestos abatement at 3822 Northern Avenue in Spring Park, MN. All materials listed on the pre demolition surveys were removed and will be disposed of in EPA approved landfills. All work was performed according to all MPCA, MN Dept. of Health, and OSHA regulations in effect on this date. A copy of the waste manifest will be sent over once the waste is disposed of. Once again, thank you for the opportunity to provide you with our service. Please call with any questions or if you need anything else.763-244-7432. Sincerely, Brad Olsson 6009 781 Ave. N. Brooklyn Park, MN 55443 Phone 763-566-6900 Fax 763-566-6903 www.twellenv.com VONCO 11, LLC. -726543 PHONE:763-262-8662 FAX:763-262-3299 MPCA PERMIT SW580 ASBESTOS - CONTAINING MATERIAL TRANSPORT AND DISPOSAL MANIFEST IG E N E R A T O R 1. Work Site Name - Address W1 PA O,I p1 t'.►� % ------ City, St., Zip Contact's Name Contact's Phone No. 2. Abatement Contractor Twell Environmental Address 6009 78th Avenue North City, St., Zip Brooklyn Park, MN 55443 Operator's Phone 612-599-1645 5. Description of Materials PROFILE#: 14-042-28 CUSTOMER #: 1000 1 3. Waste Disposal Site VONCO M, LLC. MaNing Address 15301 -140th Ave. S.E. City, St., Zip Becker, MN 56308 Physical Site Location 2.5 miles west from Co. Rd. 11 (Be Specific) on Sherburne Ave. at JcL of 140th Ave. S.E. 4. Responsible Agency MN Pollution Control Agency Address City, St., Zip 6. Containers (No. -Type) ams - kni'5 8. Special Handling Instructions and Additional Information 19. Disposal Cell Industrial 520 Lafayette Road St. Paul, MN 55155-3896 7. Total Quantity (m3 or yd3) a, 1 10. ABATEMENT CONTRACTOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labelled/placarded, and are in all respects in proper condition for transport according Itoapplicable international and national governmental regulations. Neme & Title Printed or Typed) v4 J _Signature-� -- --- ( YP ) 1pn�� —� �j Dat �4' � t - T R A S 11. Transporter 1 (Acknowledgement of receipt of materials) NamelTitle Veit Disposal Systems, Inc. d01'� K Vr �� Signature /l Address 21075134th Avenue North _ City, St., Zip Rogers, MN 55374 phone No. Date 763-428-3867 P 12. Transporter 2 (Acknowledgement of reoeipt of materials) Namelritle _ _-- —__. Signature—_..---_____.___._ Address— - _------__ _ ___.__ _____ _ City, St., Zip _— Phone No. DISPOSAL SITE 14. Waste Disposal Site Owner or Operator: Certification of receipt of asbestos 13. TO ` Yards: materials covered by this manifest except as noted in Rem 13. Name/rifle (Printed or Typed) Signature _ _ Date —_— Ticket�j) v I : V CONTRACT R - WHITE TRANSPORTER - CANARY WASTE DISPOSAL SITE - PINK GENERATOR/OPERATOR - GOLD Thank you for your Payment! Transaction ID: 13042 Transaction Number. Transaction Type: Payment Recipient: Contractor Notes: Paid Online Fees -Permit Fee Plan Review Fee State Surcharge 1 L I I Y 01[) 'k I \,\I G IR K - City of Spring Park 4349 Warren Avenue SP MN,55384 Ph:952-442-7520 $408.07 Date: 7/14/2021 Method: Visa: **** r***-****6225 Address: 3822 NORTHERN AVENUE, SP, MN 55384 Reference: Permit Number. SP-2021-00070 Type: BLDG - Demolition for OLSONS SEWER SERVICE INC Paid 1.00 $244.50 $244.50 Paid 1.00 $158.93 $158.93 Paid 1.00 $4.64 $4.64 Total Amount: $408.07 Page 1 of 1 Printed on: 7/14/2021