Laserfiche WebLink
STRUCTURE INFORMATION: <br /> 1. Structure Dimensions 1.Structure Dimensions (continued) 2.Type of Construction <br /> a. Length (ft.)= O Number of bedrooms= 4 Wood/Frame <br /> ❑ Masonry <br /> b.Width (ft.)= t( Number of garage stalls: ❑ Metal <br /> Attached = 3 ❑ Pole Bldg. <br /> Areas in square feet Detached = W ❑ ICF <br /> c. Basement= �uNFt�. El On-site Prefab <br /> ❑ Off-site Prefab <br /> d. 1 s`Story = Z ❑ Other(please specify): <br /> e.2nd Story= ( ZS� <br /> f. '/2 Story = <br /> g.Total Area= 1 7 4'1 Z. <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 /> ❑ Proposed Building Plans <br /> ❑ MN State Energy Code Calculations and Mechanical Code Requirements Form <br /> ❑ Survey(meeting all re uirements <br /> ❑ X Stormwater Pollution Prevention Plan <br /> ❑ Hardcover Calculations •p,V <br /> ❑ A Septic System Site Evaluation Report <br /> ❑ Access Permit <br /> ❑ Wetland Buffer Im rovement Plan <br /> ❑ Engineered Plans for Retaining Walls 4 feet or above <br /> X ❑ Plan Review Fee <br /> ❑ ❑ 1 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 /> • Some or all of the information that you are asked to provide on this application is classified by State law as either private or <br /> confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. <br /> Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this information is to annually update our records and records of other governmental agencies required by law. <br /> If you refuse to supply the information,the application may not be issued. <br /> Applicant's Signature: Z&_Z946,,16 Date: Z 3 ZD <br /> Last Updated: 9/29/2009 <br /> - 18- <br />