Laserfiche WebLink
� <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dirr�ensions 1. Structure Dimensions (continued) 2.Type of Construction <br /> r <br /> a. Length (ft.)= �_ Number of bedrooms=�_ �Wood/Frame <br /> ti Masonry <br /> b.Width (ft.)= �9 Number of garage stalls: ❑ Metal <br /> Attached= 3 ❑ Pole Bldg. <br /> Areas in square feet Detached =� ❑ ICF <br /> ❑ On-site Prefab <br /> c. Basement= G3�-4- ❑ Off-site Prefab <br /> d. 1S�Story - �.p {C� ❑ Other(please specify): <br /> e.2"d Story= P 871 <br /> f. '/2 Story = _� <br /> g.Total Area= � ZZ-S <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed A licable <br /> �f ❑ Permit A lication <br /> ❑ Pro osed Buildin Plans <br /> ❑ MN State Ener Code Calculations and Mechanical Code Requirements Form <br /> � ❑ Surve meetin all re uirements <br /> ❑ `� Stormwater Pollution Prevention Plan <br /> ❑ Hardcover Calculation s o►s Sua-v� <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 /> v � -� <br /> ApplicanYs Signature: �---��-^--� Q��''�%//d Date: o�' �J C� `D� <br /> Last Updated: 6/22/2009 <br /> -20 - <br />