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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) <br /> a. Length(ft.}= z 2 Number of bedrooms=� 2. Occupancy: <br /> b.Width(ft.)= 2 Z Number of garage stalls: <br /> 3. Occupant Load: <br /> Areas in sauare feet Attached= <br /> c. Basement= Detached= 4. Type of Canstruction: <br /> d. 1S'Story = <br /> e. 2°d Story= 5. Code Edition: <br /> f. '/z Story = <br /> g.Totai Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your a lication to be rocessed: <br /> Not : <br /> Enclos A licable <br /> ❑ Buildin Permit Escrow A reement and Fees <br /> � ❑ Plan Review Fee <br /> CY O Com leted A lication Form <br /> � Pro osed Buildin Plans—2 full size sets to scale and 1 reduced 11 x 17 or 8'/z x 11 set <br /> � Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> � ❑ Surve —2 full size,to scafe meetin ALL surve re uirements <br /> B' � Hardcover Calculations <br /> � Se tic S stem Certification <br /> ❑ Minnehaha Creek Watershed District(MCWD)Permit or <br /> Dacumentation from MCWD statin no ermit is re uired <br /> O Landsca e WaAs and/or Retainin Wall Plans <br /> � ❑ Stormwater Pollution Prsvention 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 C1ty 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 hislher knowledge. The applicant recognizes that they are <br /> solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no alternative but to <br /> 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 of <br /> the data. Confiden#iaf 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 governmentai 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 othe�conditions prevent the completion of an as-built survey at the time the <br /> Certiflcate of Occupancy Is requested, a temporary Certificate of Occupancy may be issued upon recefpt of a S'i0,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> ApplicanPs Signature; Date: � � � � <br /> Owner's Signature: Date: �� �J� j(�Q <br /> Last Updated: Januery 2016 <br />