Laserfiche WebLink
1 <br /> V <br /> STRUCTURE INFORM�lT10N: ' <br /> 1.Structure Dimensions 1.Structure Dimenslons(continued) 2.Type of Construction <br /> / <br /> a.Length(ft.)= �� Number of bedrooms=� ❑Wood J Frame <br /> l�, ; [�,Masonry <br /> b.Width(ft.)= t� Number af garage stalls: ❑Metal , <br /> Attached=� ❑ Pole Bidg. <br /> Areas in sauare feet Detached= ❑ ICF <br /> ❑On-site Prefab <br /> c.Basement= _� � ❑Off-site Prefab i <br /> d. 1�`Story = ❑Other(please specify}: <br /> i <br /> e.2nd Story= ' <br /> f. %:Story = � � , <br /> g.Total Area= �����- ' � <br /> � <br /> I <br /> i <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for our a lication to be processed: i <br /> Not ' <br /> Enciosed 1lqable � <br /> ❑ ❑ Permit lication j <br /> ❑ ❑ Pro sed Buildin Plans I <br /> O O MN State Ener Code CalculaUons and Mechanical Code Re uirements Form ' <br /> ❑ ❑ Surve meetin all re uirements ' <br /> 0 Stormwater Pollution Preve�tion Plan <br /> ❑ Hardcover Calculation s ' <br /> ❑ Se tic S tem Site EvaluaUon Re ort <br /> ❑ � Access Permit <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 ACKNOWIIEDGEMENT: ' <br /> • Agrees to provide all information required or requested by the Building Department; <br /> • A�rees to pay the C�ty of Orono for engineering consultant review costs in excess of 5500; ' <br /> • Certifies that the infotmation 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 appiication being aware that upon failure to do so, the staff has no altemative <br /> but to reject it until it is complete; i <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 Gassified 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 aur records and records of other govemmental 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 condltions prevent the completion of an as-built survey at the tlme the <br /> Certificate of Occupiancy is requested,a temporary Certfficate of Occupancy may be lssued upon receipt of a 510,�00 <br /> escrow to ensure completion of the as-built survey and all slte improvements. <br /> C�� <br /> Applicant's Signature: l� Date: � ` � � <br /> __. , .' � <br />