Laserfiche WebLink
�.�, zT.-e�"�.�,�...,��._,�,-�,�... �s �. .t .. ��..� - _ �---�-�-- <br /> � <br /> STRUCTURE INFORMATION: • <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length (ft.)= _���� Number of bedrooms= � �Wood/Frame <br /> b.Width (ft.)= _��� Number of garage stalls: (� Masonry <br /> Areas in square feet Attached = � ❑ Metal <br /> a�' ❑ Pole Bldg. <br /> c. Basement= '7�o Detached =� ❑ ICF <br /> d. 1 S`Story = a Q� <br /> a ❑ On-site Prefab <br />+�, e.2"d Story= N� ❑ Off-site Prefab <br /> f. '/z Story = �� ❑ Other(please specify): <br /> g.Total Area= q �6 <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed A licable <br /> ❑ Permit A lication <br /> Gd ❑ Pro osed Buildin Plans <br /> ❑ T� MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> ❑ Surve meetin all re uirements <br /> ❑ ❑ Stormwater Pollution Prevention Plan ; c v�u <br /> ❑ ❑ Hardcover Calculation s �:;>> ', ��� <br /> ❑ � Se tic S stem Site Evaluation Re ort <br /> ❑ Access Permit <br /> ❑ Wetland Buffer Im rovement Plan <br /> ❑ .S� En ineered Plans for Retainin Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ ❑ Application Escrow&Agreement �,rj }.��� �`Li <br /> ❑ . ❑ Other: <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 <br /> are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative <br /> but to 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 , <br /> of 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 completion of t as-built rvey and all site improvements. <br /> /�i � I�'-�"'� Date: /���� ��,� � <br /> ApplicanYs Signature: � � <br /> s Owner's Signature: � Date: l � I <br /> � <br />