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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= Number of bedrooms= <br /> ❑Wood/Frame <br /> b.Wipth(ft.)= Number of garage stalls: ❑Masonry <br /> Area�in square feet Attached= ❑Metal <br /> ❑Pole Bldg. <br /> c. Ba�ement= Detached= ❑ ICF <br /> d. 1s1 Story = <br /> ❑On-site Prefab <br /> e.2nd Story= ❑Off-site Prefab <br /> f. 'h Story = ❑Other(please speci <br /> fY): <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your ap lication to be processed: <br /> Not <br /> E closed A iicable ! <br /> ❑ Permit A lication <br /> ❑ Pro osed Buildin Plans <br /> ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> ❑ SunYe meetin all re uirements <br /> ❑ ❑ Stormwater Pollution Prevention Plan <br /> ❑ Har cover Calculation s <br /> ❑ Se ic S stem Site Evaluation Re ort <br /> ❑ Ac ss Permit <br /> ❑ Wet and Buffer Im rovement Plan <br /> � En neered Plans for Retainin Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ ❑ Oth�r: <br /> APPLICANT/OWNER ACKNOWLEDGEMENT: <br /> . Agrees to provide all information required or requested by the Building Department; <br /> • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; <br /> • Certifies that the information suppli�d is true and correct to the best of his/her knowledge. The applicant recognizes that they <br /> are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative <br /> but to reject it until it is complete; <br /> • Acknowledges the Escrow Agreeme�t is completed and signed; <br /> • Understands some or all of the information that you are asked to provide on this application is classified by State law as either <br /> private or confidential. Private data�is information which generally cannot be given to the public but can be given to the subject <br /> of the data. Confidential data is infarmation which generally cannot be given to either the public or the subject of the data. Our <br /> purpose and intended use of this irhformation is to annually update our records and records of other governmental agencies <br /> required by law. If you refuse to supply the information,the application may not be issued. <br /> •� ` ��►�t t�t�11��4�#� �`�'�`����� ��k�����tp��tn o��,a��Ht�#����;����'�e <br /> G`��'e:i�E��,���� ,� ' ���i���y i4t�i�t��i�i`irV�e���'a�1 a,t�00 <br /> e���c�pr'�b�i�s��r�t�n $�=t�a�F� '.�#����-ir�i��r+�fti�. <br /> �� i l <br /> ApplicanYs Signature: Date: �/'�l�'E� <br /> Owner"s Signature: I Date: <br /> Packet Last Updated: 03-06-2012 ! <br /> -22- <br />