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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Constructlon <br /> ► <br /> a. Length(ft.)= a� Number of bedrooms= Wood/Frame <br /> ) Masonry <br /> b.Width(ft.)= � Number of garage stalls: ❑Metal <br /> Attached= ❑Pole Bldg. <br /> Ar�as in sauare feet Detached= ❑ICF <br /> ❑On-site P�efab <br /> c. Basement= ❑Off-site Prefab <br /> d. 1�`Story = ,�1 �/ ❑�her(please speaTy): <br /> �" �� <br /> e.2"�Story= <br /> f. %2 Story = <br /> g.Total Area= �/Y� <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for our application to be processed: <br /> Not <br /> Enclosed A licable <br /> ❑ Permit lication <br /> � ❑ Pro sed Buildin Plans <br /> ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> ❑ ❑ Surve meetin all r uirements <br /> ❑ ❑ Stormwater Pollution Preverrtion Plan <br /> ❑ � Hardcover Calculation s <br /> ❑ ❑ Se tic S stem Site Evaluation Re rt <br /> ❑ ❑ Access Permit <br /> ❑ ❑ WeUand 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 5500; <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 altemative <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 dassified 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 subjed 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 govemmental agencies required by law. <br /> If you refuse to supply the intormation,the application may not be issued. <br /> j 1/� p� <br /> ApplicanYs Signature: Date: <br /> Last Updated: 9/29l2009 <br /> - 18- <br />