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' STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a.Length(ft)= 61 Number of bedrooms= 3 Wood/Frame <br /> Masonry <br /> b.Width(ft.)= 24/52 Number of garsge stalls: ❑Mehl <br /> Attached= CC ❑Pole Bldg. <br /> Areas in souare feet Detached= - ❑ICF <br /> 1440 ❑On-site Prefab <br /> c.Basement= ❑Off-site Prefab <br /> d. 1'u Story = 0 Other(ase specify): <br /> e.2nd Story= -- <br /> f. %Story = -- <br /> g.Total Area= 3504 <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to beprocessed: <br /> Not <br /> Enclosed Applicable <br /> ❑ Permit Application <br /> ❑ Proposed Building Plans <br /> ❑ MN State Energy Code CaWations and Mechanical Code Requirements Form <br /> ❑ <br /> Survey(meeting all requirements) <br /> ■ ❑ Siormwater Pollution Prevention Pian <br /> ❑ Hardcover Calculatio s <br /> ❑ All Septic System Site Evaluation Report New Septic - Hayes o n S <br /> ❑ t Access Permit <br /> ❑ a Wetland Buffer Improvement Plan MR DocumentAttached <br /> ❑ JP Engineered Plarms for Retaininci Weis 4 feet or above <br /> ❑ ■ Plan Review Fee <br /> ❑ ■ Other <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Building Department; <br /> • Agrees to pay time City of Orono for engineering consultant review costs in excess of$500; <br /> • Certifies that the information supplied is true and correct lb the best of hWher 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 /> • Understands some or all of the information that you are asked to provide on this application is classified by State law as either <br /> private or confidential. Private data is information which generally cannot be given ID the public but can be given to the subject <br /> of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our <br /> purpose and untended use of this information is to annually update our records and records of other governmental agencies <br /> required by law. If you refuse m supply the information,time application may not be issued. <br /> • Agrees that In the event that weather or other conditions prevent the completion of an as-built survey at the time the <br /> Certificate of Occupancy is req ted,a temporary Cerdfl f Occupancy may be Issued upon receipt of a $10,000 <br /> escrow to ensure completion of a as wilt sunre site provements. <br /> Applicant's Signature: ate: <br /> Last Updated: 4!26/2011 <br /> -20- <br />