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.k , <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structuire 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 sguare feet Attached= <br /> c. Basement= Detached� 4. Type of Construction: �J � <br /> d. 1 S�Story = /� <br /> e.2"d Story= 5. Code Edition: �!��/"��� <br /> f. YZ Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted ir� order for your application to be processed: <br /> Not <br /> Enclosed A licable <br /> �[ ❑ Buildin Permit Escrow A reement and Fees <br /> � ❑ Plan Revi�w Fee <br /> � ❑ Com lete A lication Form <br /> 8I ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/:x 11 set <br /> ❑ J� Minnesotal State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ � Surve —2 full size,to scale meetin ALL surve re uirements <br /> O � Hardcover Calculations <br /> ❑ �C Septic S stem Certification <br /> ❑ �1 Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD statin no ermit is re uired <br /> ❑ Landsca Walls and/or Retainin Wall Plans <br /> ❑ � Stormwat r Pollution Prevention Plan SWPPP <br /> ❑ � Access P rmit <br /> � � Data Priv�cy Advisory Form <br /> APPLICANT/OWNER ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required pr 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 trwe 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 informatian that you are asked to provide on this application is classified by State law as either <br /> private or confidential. Private data is infotmation 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 r other conditionsprevent the completlon 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 completion of the as 'uilt survey and all site improvements. <br /> ApplicanYs Signature: Date: <br /> / i <br /> Owner's Signature: � Date: /� / <br /> , <br /> Last Updated: January 2016 � <br />