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Sep-03-2009 02:55pm From-CITY OF ORONO +9522494616 T-770 P.002/002 F-911 <br /> STRUCTURE INFORMATION: <br /> 1,Structure Dimensions 1,Structure Dimensions(continued) 2.Type of Construction <br /> a.Length(fk)= Number of bedrooms= ®Wood/Frame <br /> El Masonry <br /> b.Width(ft.)- U+ Number of garage stalls: © Metal <br /> Attached= Pole Bldg. <br /> Areas in souare feet Detached= ❑ ICF <br /> ❑ On-site Prefab <br /> c. Basement= Off-site Prefab <br /> d. 14 Story = [� Other(please specify): <br /> e.2""Story <br /> f %Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to beprocessed: <br /> a^' PEn ace 'Tici ble.1 <br /> ❑ ❑ Permit Application <br /> ❑ ❑ Proposed Building Plans <br /> Q ❑ MN State EneEgy Code Calculations and Mechanical Code Requirements Form <br /> ❑ 17 Survey(meeting all uirements <br /> ❑ Cl Stomtwater Pollution Prevention Plan <br /> ❑ ❑ Hardcover Calculation(s) <br /> ❑ ❑ Septic System Site Evaluation Report <br /> ❑ ❑ Access Permit <br /> Q ❑ Wetland Buffer Improvement Plan <br /> ❑ ❑ I En ineered Plans for Retaining Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> 0 ❑ I Other <br /> APPLICANT,ACKNOWLEDGEMENT: <br /> -t. 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 submitdng a complete application being aware that upon failure td do so,the staff has no alternative <br /> but to reject it undl it Is complete; <br /> « Acknowledges the Escrow Agreement is completed and signed; <br /> t 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 infonnadon which generally cannot be given to the public but can be given to the subject of the data. <br /> Confidential date 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 refusa to supply the Information,the application may not be issued. <br /> Applicant's Signature: Date: <br /> Last Updated: 5/22/2009 <br /> -20- <br />