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f <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= g� Number of bedrooms= � <br /> �Wood/Frame <br /> b.Width(ft.)= � Number of garage stalls: ❑Masonry <br /> Areas in square feet Attached= �Metal <br /> ❑Pole Bldg. <br /> c. Basement= Detached= ❑ICF <br /> d. 151 Story = �, ��� ❑On-site Prefab <br /> e.2"d Story= <br /> ❑Off-site Prefab <br /> f. '/z Story = <br /> ❑Other(piease specify): <br /> g.Total Area= �►�d�U <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 /> ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ Plan Review Fee <br /> ❑ Com leted A lication Form <br /> ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8 YZ x 11 set <br /> ❑ � Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ Surve —2 futl size,to scale meetin ALL surve re uirements <br /> ❑ Hardcover Calculations <br /> ❑ Se tic S stem Certification <br /> � ❑ Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD statin no ermit is re uired <br /> ❑ Landsca e Walls and/or Retainin Wall Plans <br /> ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ Access Permit <br /> ❑ Data Privac Adviso Form <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 are <br /> solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no alternative but to <br /> 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 of <br /> 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 a10,000 <br /> escrow to ensure completion of the as-built survey and all site improvemenffi. <br /> ApplicanYs Signature: - J .� � � Date: �-�S - 2t-1 "► <br /> Owner's Signature: � Date: <br /> Packet Last Updated: August 2015 <br /> Page 22 <br />