2013-01052 (new structure) - Laserfiche WebLink

Home Browse Search

,i _ . STRUCTURE INFORMATION: - — ------____..__. 1.Structure imensions t.Structure Dimensions(continued) 2.Type of Construction o�t E�. A�.�.... a.Length(ft.)= �p�'^3�� Number of bedrooms=�_ �W�d 1 Frame i b.Width(ft.)= �__ Number of garage stalls: ❑Masonry Areas in sauare feet Attached=_�_ ❑Metal ❑Pole Bidg. c.BasemenY– �� Detached= ❑ICF d. 1�`5tory = �,_sy a ❑On-site Prefab e.2°0 Story= �'1 f�_ ❑Qff-site Prefab f. Yz Story = �i '•�t ❑Other(please specify): _ g.Total Area= ��'3� REQUIRED SUBMITTALS: All of the information must be submitted in order for our a lication to be rocessed: Not Enclosed A licabla ❑ Permit Ao lication ❑ Pro osed Buildinq Plans ❑ MN State Ener Code Calculations and Mechanicai Code Re uirsments Form ❑ Surve meetin all re uirementsl ❑ Stortnwater Pollution Prevention Plan ❑ Hardcover Calculation s ❑ Se tic S stem Site Evaluation RepoR ❑ Access Permit Wetland Buffer Im rovement Plan Engineered Plans for Retaining Walis 4 feet or above C� � ❑ Minnehaha Creek Watershed District Permit s ^ �. � — ��V. Z �� I ❑ Plan Review Fee � ❑ Application Escrow&Agreement ��t�a�y t T�S�� w��'1� �3�kv�.,�j �� `M1 T ❑ � Other. APPLICANT/OWNER ACKNOWLEDGEMENT: ► Agrees to provide all informa6on required or requested by the Building Department; • Agrees to pay the City of Ororto fo�engineering consultant review costs in excess of s500; � • Cartifias that the information supplied is ttue and correct to the best of hislher knowiedge. The applicant recognfzes that they are solaly responsible for submitting a compiete app{ication being aware that upon failure to do so, �he staff has no altemative but to reject it until it is complete; . Acknowledges the Escrow Agreeme�t is completed and signed; • Understands some or all o(the infoRnation that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generall;r cannot tre given to the public but can be given to the subject of the data. Confidentiai data is information�rohicn generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this infarma6on is to annually update our records and records of other govemmentai agencies � required by law. If you refuse to supply the information,the application may not be lssued. • Agrees that in the event that weather or other conditions prevent the completlo�of an as-built survey at tha time the Cert'rficate of Occupancy is requeated,a temporary Certificate of Occupancy may be issued upon receipt of a$10,000 escrow to ensure completion of the as-built survey and all site improvemants. �:=, '� 1-'��P-iT' 'c' r"�►i�.i 5`��=�".� , �i-�:_-.. ApplicanYs Signature: � W tN ` - Date: �?��J�-� r � _i _.._ . : Owner's Signature: }�- " `� . ..�"�.. - `--- Date: �� _�r1 �� ..,� .�--� � ,