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STRUCTURE INFORMATION: <br /> 1. Structure Dimensions 1.Structure Dimensions (continued) 2. Type of Construction <br /> a. Length (ft.)= 7i Number of bedrooms= ❑Wood/Frame <br /> ❑ Masonry <br /> b.Width (ft.)= ( Number of garage stalls: ❑ Metal <br /> Attached= ❑ Pole Bldg. <br /> Areas in square feet Detached = ❑ ICF <br /> ❑ On-site Prefab <br /> c. Basement= • ❑ Off-site Prefab <br /> d. 1st Story = 1:1Other(please specify): <br /> e.2nd Story= fbVz2f <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 /> e� ❑ I Permit Application <br /> ❑ ern-- Proposed Building Plans <br /> ❑ �' MN State Ener y Code Calculations and Mechanical Code Requirements Form <br /> ❑ �9- -' all requirements) <br /> ❑ -‹E"' Stormwater Pollution Prevention Plan <br /> ❑ Hardcover Calculation(s) <br /> ❑ --�' Septic System Site Evaluation Report <br /> ❑ �—' Access Permit <br /> ❑ ��' Wetland Buffer Improvement Plan <br /> ❑ Engineered Plans for Retaining Walls 4 feet or above <br /> ❑ Plan Review Fee <br /> ❑ i7 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: Date: , 3 <br /> Last Updated: 6/22/2009 <br /> -20 - <br />