2016-00517 - detached garage - Laserfiche WebLink

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STRUCTURE INFORMATION: 1.Structure Dimenstons 1.Structure Dlmenslona(conttnued) 2.Type of Constructfon a.Length{ft.}= Z-Z Number of bedrooms= � �W�� me ��J'� �� J�C b.Wldth(ft.r Z Z' Number of garage stalls: Z ❑ ason Areas in saua�e fe�t Attached= d ❑ tal �/1 �` � c.8asement= Detached= z �� f��l�/�G �� d. 1st S t o ry = ❑ n-s e Prefab e.2nd Story= - Prefab f. '/Story = Other lease specify): g.Total Area= REQUIRED SUBMITTALS: ' Ait of the information must be submitted in order for your application to be processed: Not Enclosed licable ❑ � Buildin Permit Escrow A reement and Fees ❑ ❑ Plan Revlew Fee C4-- ❑ Com leted lication Form B� ❑ Pro osed Bulidfn Plans—2 fuil size sets to scale and 1 reduced 11 x 17 or 8'/Z x 11 set ❑ C9— Minnesota State Ene Code Calculations and Mechanicai Code Re uirements [Y ❑ Surve —2 full stze,to scale meetin ALL surve re uiremenfs B" ❑ Hardcover Calculadons ❑ B� Se tic S stem Certification O Ei— Minnehaha Creek Watershed District(MCWD)PemUt or Documentatlon irom MCWD statin no errnit is r ired LR� ❑ Landsca e Walls andlor Retainln Wall Plans ❑ fsY Stormwater Poflutlon Prevention Plan SWPPP ❑ LL� Access Permtt LL� ❑ Data Pdvacy Advisory Form APPLfCANTlOWNER ACKNOWf..EDGEMENT: . Agrees to provide all informatl�n required or requested by the Building Department; . Agrees to pay the City of Orono for engineering consultant revlew costs in excess of�500; . Certifies that the information suppi(ed is true and co�rect to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete app{ication being aware that upon failure to do so, the staff has no alternative but to reJect it urTtil it is complete; • Acknowledges the Escrow Agreement is completed and s(gned; • Understands some or aA of the informa�on that you are asked to provide on this appfication is classified by State Maw as either private or confldential. Private data Is ir�formatlon whlch generally cannot be given to the publ'�c but can be given to the subJect of the data. Confidential data is information which generally cannot be given to e'dher the pubiic or the subject of the data. Our purpose and infended use of this Informatlon is to annually update otx records and records of other govemmental agencies requ'ired by law. lf yau refuse to supply the informatfon,the applicafion may not be fssued. • Agrees that tn the event that weather or other conditlan� prevent the completion of an as-bulit survey at the ttme the Certiflcafe of Occupancy Is roquested, a tempor�ary Certtflcate of Occupancy may bs fssued upon recelpt nf a�10,000 escrow to ensure comp[etlon of tha aa-built rurvey and atl Bfte lmprovements. ApplicanYs Signature: Date: � �Z /� Owner's Signature: Date: _ Sv�/2/��' Leaf Updated: January 2015 /�//�/�� y"-{� �s�