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✓ + <br /> STRUCTURE INFORMATION: <br /> 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction <br />: � <br />, a. Length(ft.)= Number of bedrooms= Wood/Frame <br /> ❑ Masonry <br /> b.Width(ft.}= Number of garage stalls: ❑ Metal <br /> Attached= ❑ Pole Bidg. <br />_ Areas in square feet Detached= ❑ ICF <br /> ❑ On-site Prefab <br /> c. Basement= ❑ Off-site Prefab <br /> d. 15t Story = ❑ Other(please specify): <br /> e. 2"d Story= <br /> f. '/z Story = <br /> ''� g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed Applicable <br /> ❑ Permit Application <br /> ❑ Pro osed Buildin Plans <br /> ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> ❑ j� Surve meetin all re uirements <br /> ❑ � Stormwater Pollution Prevention Plan <br /> ❑ Hardcover Calculation(s <br /> ❑ ;� Se tic S stem Site Evaluation Report <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 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 /> Iof the data. Confidential data is inforrnation which generally cannot be given to either the pubfic 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 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 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 agreement to ensure completion of the as-built survey and all site improvements. <br /> � <br /> ApplicanYsSignature: \ Date: 7'.� ' � � <br /> �< <br /> i <br />' � ,i <br />