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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions : ,� 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length (ft.)= �� �` ;�� Number of bedrooms= j�Wood/Frame <br /> b.Width(ft.)= �1� `� Number of garage stalis: ❑ Masonry <br /> .�...7�� ;�� �� ,� ❑ Metal <br /> Areas in sauare feet`� K '` Attached= <br /> � G`t ❑ Pole Bidg. <br /> a Basement= Detached = ❑ ICF <br /> d. 15�Story = ❑ On-site Prefab <br /> e.2"d Story= ❑ Off-site Prefab <br /> f. YZ Story = ❑Other(please specify): <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> Alt of the information must be submitted in order for your application to be proc�ssed: <br /> Not <br /> Enclosed Ap licable <br /> p ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ ❑ Plan Review Fee <br /> ,p-�- ❑ Com leted A lication Form <br /> „�.-° ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/2 x 11 set <br /> ❑ _,@~ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ ❑ Surve —2 full size,to scale meetin ALL surve re uirements) <br /> �°°' ❑ Hardcover Calculations <br /> ❑ Se tic S stem Certification <br /> ❑ Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD statin no ermit is re uired <br /> ❑ Landsca e Walls and/or Retainin Wall Plans <br /> ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ Access Permit <br /> ❑ ,�' Data Privacy Advisory Form <br /> APPLICANT/OWNER 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 /> • Understands some or all of the information 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 <br /> of 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 annualfy 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 /> Gertificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a 510,000 <br /> escrow to ensure completion o#the as-built survey and all site improvements. � <br /> :P ._ - � <br /> ..s.� .�.. ��"F �'.��_ <br /> `7 �, <br /> _ ___. � 1 _ � � <br /> ApplicanYs Signature. Date: - <br /> `�. �,�2 ��- Date: �� <br /> Owner's Signature: <br /> Last Updated: January 2015 <br />