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2016-00242 - antenna replacement
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2345 Blaine Avenue - PID: 17-117-23-34-0011
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2016-00242 - antenna replacement
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Last modified
8/22/2023 3:37:12 PM
Creation date
5/19/2016 4:21:50 PM
Metadata
Fields
Template:
x Address Old
House Number
2345
Street Name
Blaine
Street Type
Avenue
Address
2345 Blaine Avenue
Document Type
Permits/Inspections
PIN
1711723340011
Supplemental fields
ProcessedPID
Updated
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, , <br /> STRUCTURE INFORMATION: SE� �4,VT'�iYN�- SL�� /-}-l�pL.�Cf}-i^ic�^J <br /> 1.Structure Dimensions .Structure Dimensions(continued) � <br /> � <br /> a. Length(ft.)= Number of bedrooms= 2. Occupancy: <br /> b.Width(ft.)= Number of garage stalls: <br /> 3. Occupant Load: <br /> Areas in square feet Attached= <br /> c. Basement= Detached = 4. Type of Constructi <br /> d. 15'Story = <br /> e. 2"d Story 5. Code E on: <br /> f. '/2 S ry = <br /> g. otal Area= <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 /> ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ Plan Review Fee <br /> ❑ ❑ Com leted A lication Form <br /> ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/�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 /> ❑ � 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 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 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 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 the 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 all site improvements. <br /> ApplicanYs Signature: S� l�,�v�t..�.�lry s,T� >9,0��,c�9-��n/ Date: <br /> Owner's Signature: Date: <br /> Last Updated: January 2016 <br />
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