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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.Width(ft.)= Number of garage stalls: ❑ Masonry <br /> Areas in sauare feet Attached= ❑ Metal <br /> ❑ Pole Bldg. <br /> c. Basement= Detached= ❑ ICF <br /> d. 1 S`Story = <br /> ❑On-site Prefab <br /> e.2"d Story= <br /> ❑Off-site Prefab <br /> f. %Story = ❑Other(please specify): <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed A licable <br /> 0 ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ ❑ Plan Review Fee <br /> � ❑ Com leted A lication Form <br /> ❑ � Pro osed Buildin Plans-2 full size sets,to scale and 1 reduced 11 x 17 or 8'/x 11 set <br /> ❑ � Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ I� Surve -2 full size,to scale meetin ALL surve re uirements <br /> ❑ � Hardcover Calculations <br /> ❑ 1S Se tic S stem Certification <br /> ❑ � Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD statin no ermit is r uired <br /> � O Landsca Walls and/or Retainin Wall Plans <br /> ❑ � Stormwater Pollution Prevention Plan SWPPP <br /> ❑ � Access Permit <br /> ❑ � Data Privacy Advisory Form <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 supplied 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 Agreement 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 information which generally cannot be given to either the public or the subject of the data. Our <br /> purpose and intended use of this information 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 /> • Agrees that in the event that weather or other condi�ons prevent the compleUon of an as-built survey at the time t�e <br /> Certiflcate of Occupancy Is requested,a temporary Certiticate of Occupancy may be Issued upon recetpf oi a 510,000 <br /> escrow to ensure completion of the as-built survey and all si�e Improvements. <br /> ApplicanYs Signature: Date: <br /> Owner's Signature: �' ec �-w..� h�o.�C�c--� Date: -�I �� � � t" <br /> Last Updated: January 2015 <br />