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STRt�;TURE INFORMATION: <br /> 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction <br /> a. Length (ft.)= 60� Number of bedrooms= � <br /> ❑ Wood/Frame <br /> � b. Width(ft.)= 40� Number of garage stalls: ❑ Masonry <br /> Areas m square feet Attached= ❑ Metal <br /> � Pole Bldg. <br /> c. Basement= Detached = 2 <br /> d. 151 Story = ❑ ICF <br /> � e. 2"d Story= ❑ On-site Prefab <br /> � f. '/2 Story - ❑ Off-site Prefab <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 Applicable <br /> � � Buildin Permit Escrow A reement and Fees <br /> � � Plan Review Fee <br /> D Com leted Application Form <br /> � � ❑ Pro osed Buildin Plans-2 full size sets,to scale and 1 reduced 11 x 17 or 8 YZ x 11 set <br /> � Minnesota State Ener Code Calculations and Mechanical Code R uirements <br /> � Surve -2 full size, to scale meetin ALL surve re uirements <br /> � Hardcover Calculations <br /> � 1� Se tic S stem Certification <br /> � � Minnehaha Creek Watershed District(MCWD) Permit or <br /> Documentation from MCWD stating no permit is required <br /> � � Landsca e Walls andlor Retamin Wall Plans - <br /> � Stormwater Pollution Prevention Plan SWPPP pp� <br /> � Access Permit <br /> � �Q Data Privac Adviso Form <br /> APPLICANT/OWNER ACKNOWLEDGEMENT: <br /> ' • Agrees to provide all information required or requested by the Building Department; <br /> • Ag�ees to pay the City of Orono for engineering consuttant 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 infarmation 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 compfetion of the as-built survey and all site improvements. <br /> ApplicanYs Signature: - Date: O�- Z,g <-�� <br /> Owner s Signature: Date: <br /> Packet�ast Updated: August 2015 <br /> Page 22 <br />