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� _. airuc�ure uunerisions � i. auucture uirnensions lcvnunuea� � c. �yp�v� �.ons�rucuvn i <br /> � a. Length(ft.)= 96'-4 1/4" Number of bedrooms= 4 i <br /> � ! �Wood/Frame <br /> � b. Width(ft.)= 70'-10" I Number of garage stalls: � � Masonry � <br /> IAreas in sauare feet Attached= 3 ❑ Metal <br /> ❑ Pole Bidg. I <br /> c. Basement= Detached= � �C� <br /> d. 1 S'Story = 4249 sq ft <br /> e.2"d Story= 1286 sq ft I ❑ On-site Prefab <br /> ❑ Off-site Prefab <br /> f. '/z Story = <br /> ❑ Other(please specify): <br /> g.Total Area= 5535 sq ft <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your appiication to be processed: <br /> N ot <br /> Enclosed A licable <br /> m ❑ Buildin Permit Escrow A reement and Fees <br /> � ❑ Plan Review Fee <br /> � ❑ Com leted A lication Form <br /> k�. ❑ 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 requirements <br /> � ❑ Hardcover Calculations <br /> ❑ 1� 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 Walis and/or Retainin Wall Plans <br /> ❑ ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ ❑ Access Permit <br /> � ❑ Data Privac Adviso 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 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 information that you are asked to provide on this application is cfassified 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 #he 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 completion of the as-built survey and a!I site improvements. <br /> i <br /> ApplicanYs Signature: C��� Date: �� � �'� ��� <br /> Jwner's Sianature: �1 f''1 Date: 1 0 � <br /> -� �����i /�(�� RECEIVED <br /> � `� / � <br /> F'rn � r� �r11�i <br /> ClTY OF ORONO <br />