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APPLICANT/OWNER ACKNOWLEDGEMENT: <br /> • ApplicantlOwner agrees m provide all in�rmatian rec�ired or re�ed by the P�ming Dspertrnet� <br /> . Qwner agrees to pay tl�e City o�f Orono for enQlneerin�conaultant revlew costs where ap{�icable; <br /> . AppiicaMlOwner cert'rfies that the iMormation supplied is tr�and correet to the best of h�fier knowledge. The appbc�nt recognizes <br /> that they are �lely reepansible for submitting a compleba appiic�tion beir� aware that upan fe�ure to do so, the stafF has no <br /> atternative but to rejed it urrtil it is comple�e; <br /> • Appiicant acknowlsdges the attached Escrow Aereement is completed and signed by Owner, <br /> • Applicant/Owner u�derstands thefr proJect may requlre an Mitlal and as-built sunrey p�City Code Sectbn K�B. <br /> • Some or all of the irtfom�ation that you are asked to provide on fhis application is c�ssified by Statie law as eitl�er private or <br /> co�'iderrtial. Pr'rvate ��is iMormation which generally cannot be given to the public but c�n be given bo the subjeet ot the data. <br /> Cortfidential data is irtfortnation which generally cannot be given� eitlier the public or the subject of the data. Ow purpose and <br /> iMended use of tt�s iirformation is to ann�dy update our reoords and records of other govemmecrtal�encies required by law. If <br /> u refuae to su I the iMormation the a ication rr� not be�d. <br /> The undersigned certify that the inf rmatio u ied i e and orrect to the best of their knowledqe <br /> Applicant's Signature: � Date: ���-//� <br /> Property Owner's Signature: � �'✓/s �'✓/� 27�ate,� <br /> ,� � c <br /> 3UBMISSION REQUIREMENTS: Except for tree rsmoval permita, all permits require a complebed <br /> TYPE OF PERMIT: appiicatbn torm,escrow agreement(slgned by the property owneh and escrow cbeck from owner, <br /> twro coples ot all plans,and tlrr�copfes oi ail g�adfng plans or surveys/sfte pians <br /> [?ock,Commercial 1. 8trudural plans for tl�e dodc <br /> 2. Survey showinp the propoaed locatbn ot the dock <br /> 3. Copy of LMCD permit <br /> Dock,Residentla) Seaaonal Dodc-s�vey ahowinp proposed dock <br /> Permanerrt Dock- r�s�a roved CUP and of LMCD f ae <br /> Hardcover Permlt 1. All Mfnor or Ma�r Land Alteration Permit�eq�remerks apply as appnopriate <br /> Z. Hardcover ca�ulations,existinp and propoaed <br /> 3. Survey <br /> Land Alteration,MaJor 1. Surveylgrading plan induding�np and proposed cor#ours as approved by Conditional Use Permit <br /> 2. Erosion control plan. <br /> 3. A copy ot Mi►meh�he Creek Waterahed District(MCWDj perm�s or documer�atbn from the MCWD atatlng the <br /> propoeed project does not biyyer arry ot their permktinp req�remet�hs. Piease note,fhe City wlll not iswe a <br /> buNdi rmit without intormadon trom tbe MCWD. <br /> Land Alteratlon,Mlnor 1. Survey/grading pl�n fr�chrding existirg and proposed cwrtoura <br /> (Lesa than 10 cu.yds. 2• Amaxrt oi fill to be irnpoRed and/or exported and traW route <br /> within 75'of lake or le� 3. Ama�t of earth to be moved arourid on s�e <br /> than 501 cu.yds 4. Erosion corrtrol ptan. <br /> elsewheroe.) 5. A copy of Mirmehaha Creek Waterahed Dfatrk;t(MCWD)pem►ks w docwnet�ation irwn the MCWD staHng the <br /> propoeed project�es not Mpper ariy of thefr pem�ttinp req�rremer�a. Please no�e,the Cfty wfii�t issue a <br /> buildi rmk wtttwut information from the MCWD. <br /> Retalning Wall 1. Plansforwall(s) <br /> 2. UMess repair or exact replacement of exkdnp rv�q,submit an updated s�xvey with gradiny p�n includirig existing and <br /> propoaed�ntours <br /> 3. Hardcover caiculation vwrksheets if in shoreland distrid <br /> 4. Erosbn corrtrol plan <br /> 5. A copy of Minnehaha Creek Watershed District(MCWD)permds or documentation from the AACWD stating the <br /> propoeed proJect does not tri�er any ot their pertnittinp reqWremerRs. Ple�se nots,the Clty will not issue a <br /> bufldin rmit wltl�out Information trom the ML'WD. <br /> Stafrway or LHts bo 1. Constn�ction plaru�or stai►v�ay or lift,including footinps <br /> Lake 2. Topographicai aurvey of�operty with proposed stairs or IiR shown <br /> 3. Erosion corttrol pian <br /> 4. A copy of Minnehaha Creek Waterstred District(NK�IVD)permks or documentatbn from the MCWD statlng the <br /> proposed project does not Mgper any of their pertnktinp requiremerds. Pl�se note,the City will not is:ue a <br /> bufldi rmk wittaut information from the MCWD. <br /> Structurse Perntit 1. Construction plans. <br /> 2. Survey of property with proposed stnrcture shawn and with setbacks to property 6nes,other etnxxures on property <br /> and the septfc system indicated.The generel bcation of any sew�er and water seMces stauld be shown if applicable. <br /> 3. Gradfny plan if gradiny is proposed. <br /> 4. Hardcover ca�uladon vwrksheeta <br /> 5. Erosion control plan. <br /> 6. A copy ot Minnehaha Creek Waterahed District(MCWD)pertnits or documerrtation from the MCWD statlng the <br /> proposed proJect does not triyger any ot their permittinp requfrements. Please note,tl�e CHy will not fswe a <br /> buildi rmk witl�out infortnatfa�irom the MCWD. <br /> Tree Removal Ca��. 952-24aA800 bo��e a sir�ple tree removal fnepedbn. A re-plardf�p p�N erosbn control/rr�sna�ment plan <br /> ired for clex dttl bucWhom or other tnlereive removai. <br /> Updated: January 2014 <br />