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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions (continued) <br /> a. Length(ft.)= Number of bedrooms= _ 2. Occupancy: 6. 4„O <br /> b.Width(ft.)= Number of garage stalls: ','� <br /> 3. Occupant Load: �� �� <br /> Areas in square feet Attached = <br /> c. Basement= Detached = 4. Type of Construction: e `cr`vs' <br /> d. 1St Story = <br /> e.2nd Story= 5. Code Edition: <br /> f. %Story = <br /> g. Total Area= <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 /> ❑ Building Permit Escrow Agreement and Fees <br /> ❑ Plan Review Fee <br /> 0 Completed Application Form <br /> 0 Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'A x 11 set <br /> O Minnesota State Energy Code Calculations and Mechanical Code Requirements <br /> O Survey—2 full size, to scale(meeting ALL survey requirements) <br /> O d21_ Hardcover Calculations <br /> ❑ g Septic System Certification <br /> ❑ Minnehaha Creek Watershed District(MCWD) Permit or <br /> Documentation from MCWD stating no permit is required <br /> O Landscape Walls and/or Retaining Wall Plans <br /> ❑ 4Y Stormwater Pollution Prevention Plan(SWPPP) <br /> ❑ Access Permit <br /> ❑ Data Privacy Advisory 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 an <br /> solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no alternative but t, <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 eithe <br /> private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject c <br /> the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. OL <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 o other conditions prevent the completion of an as-built survey at the time thi <br /> Certificate of Occupancyls requ i� 5emporary Certificate of Occupancy may be issued upon receipt of a $10,001 <br /> escrow to ensure pdmpletion of e.' wilt survey and all site improvements. <br /> jy <br /> / ( <br /> Applicant's Signature: , ;,r�' ;, � Date: <br /> 74—f/ <br /> Owner's Signature: Date: <br /> Last Updated: January 2016 <br />