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STRUCTURE INFORMATION: <br /> . 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= Number of bedrooms= [j Wood/Frame <br /> b.Width(ft.)= Number of garage stalls: 0 Masonry <br /> Areas in square feet Attached= ,'j ❑Metal <br /> 0 Pole Bldg. <br /> c. Basement= Detached= <br /> 0 ICF <br /> d. 152 Story = <br /> 0 On-site Prefab <br /> e.2"d Story= <br /> 0 Off-site Prefab <br /> f. 'A Story = <br /> 0 Other(please specify): <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 /> ❑ la Building Permit Escrow Agreement and Fees <br /> 56 0 Plan Review Fee <br /> ❑ 0 Completed Application Form <br /> I3 0 Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/4 x 11 set <br /> ❑ J.11 Minnesota State Energy Code Calculations and Mechanical Code Requirements <br /> ❑ ❑ Survey—2 full size,to scale(meeting ALL survey requirements) <br /> ❑ ❑ Hardcover Calculations <br /> ❑ -6 Septic System Certification <br /> ❑ ❑ Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD stating no permit is required <br /> ❑ iin Landscape Walls and/or Retaining Wall Plans <br /> ❑ .IRJ Stormwater Pollution Prevention Plan (SWPPP) <br /> ❑ l9 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 are <br /> solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no alternative but to <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 either <br /> private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of <br /> 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 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 or other conditions prevent the completion of an as-built survey at the time the <br /> Certificate of Occupancy is requested,a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> Applicant's Signature: .--.7.-2:: :ti) Date: I t/ 3//, <br /> Owner's Signature: } f�{ Date: I ) 3 2041 <br /> Packet Last Updated: August 2015 <br /> Page 22 <br />