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STRllC711RE 1NFOR!4lATiOfV: <br /> , �t,3�ttur+�Dimena[on� 1.BWcture Dlmerttrlonq(co+rtinuedj .'��2.Type o/�Canxtr4�c2lo� _ .— .._._� <br /> t'l�nn�h tft 1- _��?,.,? �Numhcrof betlrowns=�__ � � <br /> r �"Wootl i iremn <br /> � b �,�;csch t��}= a�.� ( Number of peroge st�s E,�Masonry ; <br /> _�ea8 ir�,f_y:ag�t Atlact�ed=� €��6tal � <br /> �! ' �PMa E31t�g. <br /> c.@asemertt= �S:?.. � C7e:a:J+cd=_ � [i iCF { <br /> d f^Story = �,. �-_. I ❑On-att9 PrefAb # <br /> r Z'"SMry= ��` � <br /> � G Off�alte Preieb � <br /> � °5 ShxY = p�/� <br /> � �i�.1'�Q ![�Uther(piease spec�ty). , <br /> �.�Os9!Fi!w'3��� ( <br /> ... ......__...___._..... �_.__._._��._ _.."'y____.. _..__._. ._I <br /> R�QUlRED 3UBM1'�'AI.S: <br /> A!!of the ir�nnnation��nust be s�bmitted in a!der for you�applicatFon to be processed: <br /> , _--—r.___ �, _ _�_.� .,�....� <br /> , Enctot�re3 ,hpnAGable �_ ,_ _....__...�..._ ___�__1 <br /> .. _ ._.._..� � <br /> CI [1 eu�d�n�Pnrtnft Escnow Agrcament e�d Fecc _ <br /> :. �..- - - _.. _ <br /> � �.--- <br /> . i7 _ Pkin Rct�sw Fce .�._ .... .�------ --, <br /> ,_....�_ .,.__ .__.__._ ____. _ �__._..._ <br /> � C"I � Co.mQ;nted Appi�cstian Fonn � <br /> :�....____. - - ___ _.�.. <br /> C u __ Pro�fosed L�u(idirs�Plans-2 full slze sets,W s�lc and 1 redcrcatl i�x t7 or II 4S x 11 se+ � <br /> __._._ _ .... <br /> 6'7 i_I Minneso2a State Ener�y Code Calculation3 ancf Meehttn�!Code Raqulr+emdnts _q, <br /> __ ____�.__. _._— .._`.�.., . ... <br /> U L7 __�5,u�+rny-2 tull s�zc.to scale(mrednp Al.L su�rr_quirarn�snts} � <br /> .. �_.�a ..._ <br /> L7 �_ O FlardtdvsrC�uw�etio�d Y...._.,. <br /> � _. __, _.. _ <br /> � � _.__ �_ . _ �Sa ,c S�stern CerllFca;ion <br /> - --.... _..._....:. _ ..-� <br /> --__—, ...._ .. G N11�n�h�hsCmektNalerx�eAD+shkt'MCWO7Pnrmi3or <br /> -- S <br /> Qocumentntton trom�CVYD staHng rna przrrrtit is re u�red <br /> _._ . _._ .!�.,__.,_._.__ . . ...._.�__..__� <br /> ""7 C7 t;andscape lNrifs:snA/n�RMtiinlnp Wall ptanx <br /> _. �_,___ w..__ _ _ .�_.� <br /> '7 � D � &tormwafnr Fo�ution?reue�0or Plan S{ YVRpPI_ <br /> _L7 (- -''.s^ ; Aacesa Perm�c .. �. . _ <br /> _W_____.. .� _.�.. . . .__.__�.._.._... <br /> �-% � _..�_�_ . Datn Prlvsc_AdYrq+Y rarm __ _ � .. _._ _ _ <br /> _, ..--- _ �Y_ <br /> APPLSGAN7IOWNEf'AGlCNOWI..ELaGEMEIVT: <br /> _ —___.._.... __... - .___.._.__. ,._ _...._ _ �__... ,..�....._ __ �., <br /> • Aqroes b provide ail kdotrtlattm roquired or requeafed by the Bulidt�q DepertmanY, � <br /> . Agreen to pay the Cky of Orono fer enginoadng consuit:nt tsvltw coari in exe�n M SlIOQ, <br /> : • CeRNlea that the tnformalbn supplied k true and oorrect Eo the best oF hialherknowledge. The applieantr�opnizsa that thay aro <br /> seiely rasponsibie(w submit6nQ a ccmplete appUcfltion being awara 1l+at upon feauro b do so.Me atefl`hes na albemative but io j <br /> releet it uMN II is contplete, { <br /> • Acknowledpea tlto Escrow Aproement Ea compiefed and siQrted; <br /> • Un�ersstands some or ail of ttb infoRnatlon ihet you aro asked la provfde on thia appilcetlon is 4aselNed by SffiIe lew as either I <br /> orivele w conRdenpaL Prlvete data ls itttom�a8on which generally eannot ps gNen Eo the public but can be piVert to thc eubJeG of � <br /> ' the date. CoMdeMlol Q�ta Is Mtomf4tion whioh penerally e�rtnot ba gfvan 10 ei��lha Dub►ic or tlrc subjxt ot fhs da4. Our <br /> purpose and ihtended uae d fhia irdortnetion is b annually upda0s our reoords end rocords of utl�er po�rommeMN apau�a j <br /> requfrtd by taw. If yoa refuse lo supply thtiMormetlon,tha sppMcatfon may nW be Isa�ed. � <br /> • �jnas lhat ia the a�aent tha�weast�t or o�lenr coadfllons p++e+re�d if+s eomQistlOet at aet aa-b[�1ft sttNlry ad#fa lier�o�n � <br /> Certiflr�.sta of Oecnparw�ia raquuat�+d.a M�wmry C+�tlHk�ttn ot Qod�psaeY maY ba 9at�wd upon mes�t Ot a f10.000 <br /> �ecmner ta onsum aqmR�ia�of dee�s-0WN sucvey smd ip aNa 1Mqtowmenfa. ? <br /> i <br /> :._,. _..._.. — - -- .. .�._.....,,_� <br /> __.__...__._... ----�...---___. <br /> ApplicanYs Signature: Date: �'��� <br /> �Qwne�'s Signature: _ _ Daie:V �I� ���� <br /> � 1 _ <br /> Packef 18s:VCdah3d Aupus!2015 <br /> p'ege Y? <br />