Laserfiche WebLink
�- <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction <br /> � <br /> a. Length (ft.)= 82 Number of bedrooms=� �Wood/Frame <br /> � ❑ Masonry <br /> b.Width (ft.)= 18 Number of garage stalls: ❑ Metal <br /> Attached =,�_ ❑ Pole Bldg. <br /> Areas in square feet Detached =� ❑ ICF <br /> ❑ On-site Prefab <br /> c. Basement= 255 � ❑ Off-site Prefab <br /> d. 1 St Story = Z'$o Z ❑ Other(please specify): <br /> e.2"d Story= _ `�_ <br /> f. '/Story = _� <br /> g.Total Area= S3 S 3 <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your appiication to be processed: <br /> N ot <br /> Enclosed A licable <br /> ❑ Permit A plication <br /> ❑ Pro osed Buildin Plans <br /> ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> �,f ❑ Surve meetin all re uirements <br /> ❑ Stormwater Pollution Prevention Plan <br /> ❑ Hardcover Calculation s <br /> ❑ �[ Se tic S stem Site Evaluation Re ort <br /> ❑ �[ Access Permit <br /> �' ❑ Wetland Buffer Im rovement Plan — $t� S p �c- <br /> ❑ En ineered Plans for Retainin Walls 4 feet or above c.r t.A. <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 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 /> O <br /> Applicant's Signature: �� Date: �i— �� —�� <br /> Last Updated: 9/29/2009 <br /> - 18 - <br />