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STRUCTURE INFORMATION: <br /> 1. Structure Dimensions 1. Structure Dimensions (continued) ' 2.Type of Construction �� <br /> i <br /> a. Length (ft.)= �_ Number of bedrooms= �Wood/Frame I <br /> � Masonry <br /> b.Width (ft.)= __�___ Number of garage stalls: ❑ Metal <br /> Attached = ❑ Pole Bldg. <br /> Areas in square feet Detached = ❑ ICF i <br /> ❑ On-site Prefab <br /> c. Basement= ❑ Off-site Prefab <br /> d. 1S`Story = ❑ Other(please specify): <br /> I � (� <br /> e. 2"d Story= w��� � ►'1..:1�C��; It@� ;"\0.S� ��� <br /> f. '/z Story = W���� 'Cf�ST ��.`r�S- <br /> g.Total Area= `l � �:���� <br /> 1� �,.,�t� a�� � s� ` a� -e.X`S�.� � � <br /> e�,� �z' -� �,.� �- �: � e.,� �, � <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 /> ❑ Permit Ap lication <br /> ❑ Pro osed Buildin Plans <br /> � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> � ❑ 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 <br /> � ❑ En ineered Plans for Retainin Walls 4 feet or above <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 /> ApplicanYs Signature: Date: � �� � <br /> Last Updated: 9/29/2009 <br /> - 18 - <br />