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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions1.Structure Dimensions(coritlnued) 2.Type of Construction <br /> a.Length(fL)= 25 ' <br /> Number of bedrooms= 2ood!Frame <br /> b.Width(fL)= &P-30' Number of garage stalls: ❑Me <br /> sonry❑Metal <br /> Areas in square feet Attached= <br /> ❑Pole Bldg. <br /> c.Basement= Detached= ❑ICF <br /> d.1'Story = ❑On-site Prefab <br /> e.2n°Story= ❑Off-site Prefab <br /> f. %]Story = ❑Other(please specify): <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be rocessed: <br /> Not <br /> Enclosed Applicable <br /> ❑ ❑ Permit Application <br /> p ❑ Pro sed Buildl Plans <br /> p ❑ MN State tnera yCode Caladations and Mechanical Code Requirements Form <br /> p ❑ Surve meed all re uirements <br /> p ❑ Stormwater Pdlutbn Prevention Plan <br /> p ❑ Hardcover Calculation s <br /> p ❑ Septic System Site Evaluation Report <br /> ❑ ❑ Access Permit <br /> p p Weiland Buffer Im rovement Plan <br /> p ❑ E ineared Plans for Reteinl Wads 4 feet or above <br /> p ❑ Minnehaha Creek Watershed District Permit(s). <br /> p ❑ Plan Review Fee <br /> p ❑ Other: <br /> APPLICANTIOWNER 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 hWher 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 /> 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 <br /> information,annually <br /> the applin our recordsmay not bee sued records of other govemmental agencies <br /> required by law. if you refuse to supply <br /> theAgrees that in the event that weather or other conditions oprev nt the c ncy may be issued upon receipt the <br /> a time <br /> the <br /> 000 <br /> Certificate of occupancy is requested,a temporary <br /> escrow to ensure completion of the as-built survey and all site Improwmerits. <br /> Date: /LLL3 <br /> Applicant's Signature: <br /> Date: <br /> Owner's Signature: <br /> Packet Last Updated: 13 page 11.113 <br />