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STRUCTURE INFORMATIOfV: . <br /> 1. Structure Dimensions 1. Structure Dimensions(continued) 2. Type of Construction > <br /> i <br /> a. Length (ft.)= 32 Number of bedrooms = <br /> ❑Wood/Frame <br /> �/ � ❑ Masonry <br /> b.Width (ft.)= 3 /2 Number of garage stalls: ❑ Metal <br /> Attached = ❑ Pole Bldg. <br /> Areas in square feet Detached = ❑ ICF <br /> c. Basement- ❑ On-site Prefab <br /> - ❑ Off-site Prefab � , / <br /> d. 1 S�Story = (�Other(please specify): h G7 c��, <br /> e. 2"d Story= <br /> f. '/z Story = <br /> g. Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> N ot <br /> Enclosed Applicable <br /> ❑ Permit Ap lication <br /> ❑ Pro osed Buildin Plans <br /> � .� MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> � S�-fe 1 a h <br /> � .0'� Stormwater Pollution Prevention Plan <br /> � �" Hardcover Calculation(s <br /> � Se tic S stem Site Evaluation Re ort <br /> � Ja' 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: 3'`/� �U <br /> Last Updated: 9/29/2009 <br /> - 18 - <br />