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2017-00112 - addn/remodel/repair
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2500 Shadywood Road - 20-117-23-11-0034
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2017-00112 - addn/remodel/repair
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Last modified
8/22/2023 3:48:02 PM
Creation date
9/25/2018 2:14:18 PM
Metadata
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Template:
x Address Old
House Number
2500
Street Name
Shadywood
Street Type
Road
Address
2500 Shadywood Road
Document Type
Permits/Inspections
PIN
2011723110034
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� � <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1. Structure Dimensions(continued) <br /> a. Length(ft.)= Number of bedrooms= 2. Occupancy: <br /> b.Width(ft.)= Number of garage stalis: <br /> 3. Occupant Load: <br /> Areas in square feet Attached = <br /> Ch��^\ s-h,�-L� <br /> c. Basement= Detached = 4. Type of Construction: <.�h��s� �= <br /> d. 1 S�Story = <br /> e.2"d Story= 1 S� ,*}- 5. Code Edition: <br /> f. '/z Story = <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 Applicable <br /> ❑ Building Permit Escrow Agreement and Fees <br /> ❑ Plan Review Fee <br /> � ❑ Completed Application 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 /> � ksl Survey—2 full size,to scale(meetin ALL survey requirements <br /> � Hardcover Calculations <br /> � �Sl Septic S stem Certification <br /> � � Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD statin no ermit is re uired <br /> � ,$1 Landscape 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 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. 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 conditions prevent the completion of an as-built survey at the time the <br /> Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 <br /> escrow to ensure co letion of the as-b 'It survey and all site improvements. <br /> ApplicanYs Signature: Date: � i <br /> Owner's Signature: t� Date: f <br /> Last Updated: Janua 01 <br />
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