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• <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length (ft.)= 76 'C. " Number of bedrooms= g Wood/Frame <br /> „ �OdER+►(E E Masonry <br /> b.Width (ft.)= 144 Number of garage stalls: ❑ Metal <br /> Attached = 3 E Pole Bldg. <br /> Areas in square feet Detached = Q( ❑ ICF <br /> E On-site Prefab <br /> c. Basement= /, 53.1 ❑ Off-site Prefab <br /> d. 1st Story = /t 53-1 ❑ Other(please specify): <br /> e. 2nd Story= /,Sl'-I <br /> f. %Story = or.VR <br /> g. Total Area= 1, C?8 <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 /> 0 Permit Application <br /> ,Q' ❑ Proposed Building Plans <br /> O +k ❑ MN State Energy Code Calculations and Mechanical Code Requirements Form <br /> 0 Survey(meeting all requirements) <br /> O if Stormwater Pollution Prevention Plan <br /> O ye X 0 Hardcover Calculation(s) <br /> .� ❑ Septic System Site Evaluation Report <br /> ❑ 1ff Access Permit <br /> O Wetland Buffer Improvement Plan (EVA tv►ATroiv/bRpwxa1G Co'"PPETeb - SEE SaevEY) <br /> O Engineered Plans for Retaining Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ 1$ Other <br /> It( SuitautRAc1oR (ova_ Su1401 z T <br /> 14( NOT NEEbEA ?ER ?REvsoas compettsArro..i w/ci rY <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; <OWA/E'/t cosCC. $RTti6 7o crTY') <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: ./UC Date: <br /> Last Updated: 5/21/2009 <br /> -21 - <br />