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, <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensfons 1.Structure Dimensions(continued) 2.Type of Construction � , y . <br /> a. Length(ft.)= �O� Number of bedrooms=� <br /> �INood/Frame <br /> b.Width(ft.)= �_ Number of garage stalls: ❑ Masonry <br /> Areas in sauare feet Attached=�_ ❑ Metal <br /> ❑ Pole Bldg. <br /> c.Basement= Detached= ❑ ICF <br /> d. 1 St Story = �Z 6 0 <br /> ❑ On-site Prefab <br /> g 2nd Story= f�[� ❑ Off-site Prefab <br /> f. %2 Story = 9�7 <br /> ❑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 A plicable <br /> ❑ ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ ❑ Plan Review Fee <br /> ❑ ❑ Com leted A lication Form <br /> 8 ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/z x 11 set <br /> ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> � ❑ Surve —2 full size,to scale meetin ALL surve re uirements <br /> ❑ ❑ Hardcover Calculations <br /> ❑ ❑ Se tic S stem Certification <br /> i� ❑ Minnehaha Creek Watershed District(MCWD)Permit or . <br /> Documentation from MCWD statin no ermit is re uired . <br /> �' ❑ Landsca e Walls and/or Retainin Wall Plans <br /> ❑ ❑ Stormwater Pollution Prevention Plan SWPPP � <br /> ❑ ❑ Access Permit <br /> ❑ ❑ Data Privac Adviso 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 altemative 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 govemmental 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 /> Certiflcate of Occupancy is requested, a temporary Certificate of Occupancy ma�be issued upon receipt of a$10,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> e <br /> ApplicanYs Signature: Date: R`, /Q/. Z�l S� <br /> Owner's Signature: Date: <br /> Packet Last Updated.• August 2095 <br /> Page 22 <br />