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STRUC�URE INFORMATION: <br /> . 1.Structure Dimensions 1.StruCture Dimensions(continued) <br /> a. Length(ft.)= Number of bedrooms=� 2. Occupancy: -_�C J � <br /> b. Width(ft.)= Number of garage stalfs: � <br /> 3. Occupant Load: — <br /> Areas in sauare feet Attached= � <br /> c. Basement= I�. E G Detached= 4. Type of Construcion: -1� ��c-� <br /> d. 15t Story = �� � <br /> e.2"d Sto 0 5. Code Edition: �-��•; �_' ����1�' <br /> ry= ! c� �l_.� <br /> f. %2 Story = <br /> / ' I <br /> g.Total Area= 4 <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'/z x 11 set <br /> ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ ❑ Surve -2 full 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 /> � ❑ Landsca e Plan <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 /> • Cefifies fhat 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 aftemative 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 applicafion 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 tF1e 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 to ensure completion of the as-built survey and all site improvements. <br /> ApplicanYs Signature: Date: I <br /> Owner's Signature: � ������ �f <br /> ��� ; � 201� <br /> Packet Last Updated: January 2016 CITY OF OR�NO <br /> Page 22 <br />