2012-00809 - screen porch - Laserfiche WebLink

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Y � r�. � STRUCTURE INFORMATION: • 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= � Number of bedrooms=,� �Wood/Frame b.Width(ft.)= 3 D� Number of garage stalls: ❑ Masonry Areas in spuare feet Attached= ❑ Metal ❑ Pole Bldg. c. Basement= Detached= ❑ ICF � d d. 1g�Story = -]n' - ❑ On-site Prefab e.2"d Story= ❑ Off-site Prefab f. '/z Story = ❑ Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable � ❑ 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/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for enginee�ing 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 th:y are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no altem�tive but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands some or all of the information that you are asked to provide on this application is classified by State la�v as either private or confidential. Private data is inforrnation which generally cannot be given to the public but can be given b the subject of the data. Confidential data is information which generally cannot be given to either the public or the subjed ofthe data. Our purpose and intended use of this information is to annually update our records and records of other govemncental agencies required by law. If you refuse to supply the information,the application may not be issued. • Agrees that in the event that weather or other conditions prevent the completion of an as-buik survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issusd upon rsceipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. � ApplicanYs Signature: Date: ��? � l� Owner's Signature: Date: Padcet Last Updated: 03-06-2012 -22-