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STRUCTURE INFORMATION: <br /> 1.Structure Dimensio s 1.Structure Dirr�nsions(contin�d) 2.Type of Construction <br /> a. Length(ft.)= � Number of bedrooms= <br /> � [�-Wood/Frame <br /> b �� � _ � Masonry <br /> ( )— Number of garage stalis: ❑ Metal <br /> Attached= ❑ Pole Bldg. <br /> Areas in sauare feet Detached= ❑ ICF <br /> c. Basement= ❑On-site Prefab <br /> ❑Off-site Prefab <br /> d. 1�'Story = ❑Other(please speaty): <br /> e.2'�Story= <br /> f. '�Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be subm�ted in order for your a plication to be rocessed: <br /> Not <br /> Encloaed A licable <br /> ❑ Permit lication <br /> � Pro osed Buildin Plans <br /> � MN State Ene Code Calculations and Mechanical Code Re uinements Form <br /> � Surve meetin all re uir+ements <br /> � Stomiwater Pollution Prevention Plan <br /> � Hardcover Calculation s <br /> � Se tic S stem Site Evaluation Re rt <br /> � Access Permif <br /> � Wetland Buffer Im rovement Plan <br /> � En ineered Plans for Retainin Walls 4 feet or above <br /> � Plan Review Fee <br /> � ❑ Other <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all infomiation 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 infortnation 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 altemative <br /> but to reject it until it is comptete; <br /> • Acknowledges the Escrow Agreement is completed and signed; <br /> • Some or all of the information that you are asked to provide on this application is classified by State law as either private or <br /> confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. <br /> Confidential data is infomiation which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this information is to annually update our necords and necorcis of other govemmental agencies required by law. <br /> !f you refuse to supply the information,the application may not be issued. <br /> ApplicanYs Signature: � � <br /> Date: <br /> Last Updated: 9/29/2009 <br /> -18- <br />