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APPLICANT/OWNER ACKNOWLEDGEMENT:
<br /> • /lppilcan��wner agrees to provlde all Informetion requlretl or requested by the Planning �epartment,
<br /> • Owner agrees to pay the City of Orono for engineering consultant revlew costs where applicable;
<br /> t • Appllcan��wner cBrtlfies thetthe informaTlon supplietl Is[rue antl co�rectto the best of hls�heY knowledga. The appliCent recognizes
<br /> Chat they ere Solely responsible for suDmitting a complete appllcetlon being awere ihat upon fallure to tlo so� the staf'f hes no
<br /> alternative butto reJect It until lt Is completB,
<br /> � Applicenc aCknoWletlyes Ch6 Htt9Ch2d ESc�Ow/19�BBmBnt13 COrtfpleted 2nd siyned byOwn �
<br /> • ApplicanUOwner understands their project may require an initial and/or as-built survey per City Code Section 86-68.
<br /> � Some or ell of the InPormeLion thet you are asked co provltle on [his appllcetlon Is clessifletl by Stete law as either prlvate or
<br /> nfitlentiel. Private tlate is In(ormation which genera�ly cennot be given io [he public but can be glven to the subJec[ of the tlaia.
<br /> Confitlential date Is Information whlch generally cennot be glVen to eltlleY ihe pub�lc or the subjec[ of the tleta. Our purpose antl
<br /> intentled use of This information is to annually uptle[e our �ecortl5 entl records Of o[he� governmental agencies requlratl by Iaw. �f
<br /> ou refuse to supply tha Informa[lon,the appllcatlon mey not De i ed.
<br /> The undersignetl cer[ify thatthe inform ti s pplie true antl correctto the best oftheir knowletlge.
<br /> Applicant's Signature: � Dete:
<br /> Property Owner's Signature: Dete: b ,s
<br /> SUBMISSION REQUIREMENTS: E.�aP� fo� t�ae �emo„e� Pa�m�t=, all permita require a completed
<br /> TYPE OF PERMIT: application form, escrow agreement(signed by the property owner)and escrow check from owner,
<br /> two copies of each,where applicable,plana,landscape plans,grading plans,surveys or site plans.
<br /> Dock,Commercial �. 5����z��a� P�e�=fo��he ae�k
<br /> Z. Survey�si e plan showing che proposetl location of the tlock
<br /> 3. CaPy e�LMCD Pa�m��
<br /> Dock,Residential Seesanel�ock�s�rvey showing proposetl tlock
<br /> Pe nt Dock�plans e epprovetl by CUP antl copy or LMCD permit�if applicable�
<br /> � HardcoverPermit �. mAll Minor o�Major Lantl Alceratian Parmii raqulraments apply a� epprop�ie2e
<br /> Z. Herecover celc�iecions, e%Isiing antl proposetl
<br /> 3. S� a,.
<br /> l.and Alteration,Major 1. $urveylgratling Pia�i��i�a��y ax�su�9 a�a proposeG�a.,<o��s es approvetl ey Co�aiiio�ai�lsa P.�.�ii
<br /> 2. E�o„o„ o�P�a.,.
<br /> 3. A�oar or Mc„�.nena C�eak Waca�znaa D�sc.i�c(MCWD) aa��,�ns o�ao��ma.,�ac�o.,r�o,,, �na MCWD s �y cna
<br /> propo aapro�accaoesooccrigqa oyorcna�rPa�.o�cc��qreqwraroa��s. Pleasenote,theCitywlllnotissuea
<br /> buiidin rmit without infortnatlon from the MCWD.
<br /> L.and Alteration,Minor �. SurveylgraAing Pia� ���i�ai�9 axiscin9 e.,a proposaA�o�co.,�s
<br /> 2. Qmount oPfill co be ImporCetl entl�or Bxporietl entl haul routa
<br /> 3. Ama„��a.ae��h�e be mo„ed e�o„�d o„ s��a
<br /> 4. E�es�o„� o�P�a,,.
<br /> b. A�oPy orMi�.,anana C�eek Waza�snaa D�svio�(MCWD) va��,�cs o�eo��,�a�ie�io�r�a,.,�na MCWD�au.,y cna
<br /> P�oposaaP�a�a�caoas �ecc�iqqa�a�yof[heirpermiiting�a,���ama.,�s. Pleasenote,theCitywillnotissuea
<br /> buildin rmit without Informadon from the MCWD.
<br /> Retaining Wall �. P�a„=.o�we��(s)
<br /> 2. Unless repair or exect replacamant oP axisting wall, submlt an updaietl survey wit1� gratling plan inclutling ex�stinq entl
<br /> proposea contours
<br /> 3. Haracova�caicuieuon worksneecs ir�n snoreiana e�sxna
<br /> 4. E�a��o„ .,��o�,�a„
<br /> 5. A�oPY o.M;,,�a�a�a C.aak Wa�e�s�ae D�s«,��(MCWD) Pa�m��� o�do��ma„�e�;o.,.�om<na MCWD s e��„9�ha
<br /> proposatl project tloas n triggar any ofcheir permlRing�aq,.��ama.,�=. Pleasenote��eC�w���AQt�ssu08
<br /> /b�uiidin rtnit without infortnaffion from the MCWD.
<br /> Stairwayor Lifts to �, l.onstrucxlon plans for scairway or IiR, inclutling footings
<br /> �ke Z. Topographical survey of property wifh proposetl stalrs or IIR shown
<br /> 3. E�os,o� o�,�a.,
<br /> 4. A�oPy orMinnaM1ehe C�.ak Waxe�snaa �isc.��c(MCWD) Pa�..,ics o�ao��ma�cecio�r�e�.cna MCWD s au�y cne
<br /> propo aaP�o�a�caeesn riggere.,yor�na�.Pe�,��z��„s�aq,.��ama��s. Pleasenote,th6CilyWIllOOtiBSU@e
<br /> buildin rmR without Infonnation from the MCWD.
<br /> Structur+e Permit i. Co.,s���«,o., P�a.,=.
<br /> Z. Survey�site plan of property wiih proposetl s ructura s�own antl wi[h setbecks to property lines, other structures on
<br /> propercy antl tha septic system Intlicatea.Tne general IoceSion of eny sewer antl watar serv�ces should be shown if
<br /> applicable.
<br /> 3. Gratling plan i/gratling Is proposetl.
<br /> 4. He�d�o„a��e��,.�a��o�wo�ksnae�s
<br /> 5. E�os�o.,� o�P�e,,.
<br /> 6. A�oar ar�Vlc.,.,anana C.aak�/Va�a�snaa ��si�i�i(MCUV�� aa�mizs o�eo��ma��aao�r�o�,nna MCWD scac�„9 ina
<br /> proposeO P�o�eccaoes ., cc�iqqar e�y ormei�Pa�m�ai�q�a,,,«ema��s. Pleasenote,theCitywillnotisauea
<br /> buildin rtnit without infortnatlon from the MCWD.
<br /> TreeRemoval Ce��: 952-249-4600 co schetlule an inspectlon Tor rsmovel of en Intliviauel trea�s�. A re-planting plen�erosion control�
<br /> age t plan mey ba equlratl/or cleer cutting,buckihorn o othar fntansive vege ation r al.
<br /> Uode�ad: Me„2015
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