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STRUCTURE INFORMATION: <br /> 1. Structure Dimensions 1. Structure Dimensions (continued) 2, Type of Construction I <br /> a. Length (ft.)= 1� mber of bedroo = Wood/ Frame <br /> i <br /> b. Width (ft.)= � ', Num of g ge stalls ❑ Metal <br /> ' Attache ❑ Pole Bldg. <br /> Areas in square feet ' Deta d - ❑ ICF <br /> c. Basement- i ❑ On-site Prefab <br /> - ❑ Off-site Prefab <br /> d. 151 Story = ❑ Other(please specify): <br /> e. 2�d Story = � <br /> f. 'h Story = � <br /> g. Total Area= <br /> � # , � . _ ' <br /> f��. � ` � ,� �' ' �.x� <br /> r �� .��. ;,ti,�' �'� ..� . � .,� . <br /> " REQUIR�FD SUBMITTALS: <br /> All of the information�must be submitted in order for your application to be processed: <br /> N ot <br /> Enclosed Applicable � <br /> � � Permit Ap lication • �, , <br /> � p I Pro osed Buildin Plans <br /> � � MN State Ener Code Calculations and Mechanicai Code R''e uirements Form <br /> � �1 Surve meetin all re uirements <br /> � � � Stormwater Pollution Prevention Plan <br /> _ � D Hardcover Calculation(s) <br /> � � Se tic S stem Site Evaluation Re ort <br /> � 0 Access Permit <br /> � � � We and Buffer Im rove ent lan <br /> � ' �►, eretl k�irr9i r Re 'nin � all� � bre <br /> � � ` Plan Reviev3 Fee . . .� � _ � .1� �:,: ' <br /> � b Other �" A. ,'* � <br /> r•� � �it . . * <br /> t � �� L ,�v �+ <br /> �'' a �� `' � "'At�,,� ���iP'��!�► * �a �'�+l�►.,��•� ��'�". �'��,'``� <br /> �w , F�L'���A�s1����WL�DG�MCN�: �, , <br /> � � �Agrees to provide all information required or requested by the Building Department; � <br /> � • � . <br /> i • Agrees to pay the City of Orono for engineering consultant review costs in excess of�500�; <br /> ; _ �a�;ifias that tha in�urr;a�;on suppiied is irue and correct to tne oest of his/her knowledge. Tne appiicant 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 /> Iconfidential. PrivMte data is information which generally cannot be given to the public but can be given to the subject of the data. <br /> Canfidenti�'I data is information which generally cannot be given to either the public or the subje�t of tl�e data. Our purpose and <br /> I intended use of this information is to annually update our records and records of other gov�1-nment�(agencies required by law� <br /> If you refuse to supply the information, the applicatiora may not be issued. �,:,, ' � w,� <br /> ���. <br /> • �' <br /> rr,:. `r <br /> * • � � <br /> ApplicanYs Signature: �, . � ' � �'��� '� ate: <br /> _ , �. <br /> * 4 ��d. <br /> Last Updated: 9/29/2009 , <br /> - 18 - <br /> �,�,,.� . .. .,_.. . Y_,�.. <br />