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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensio�s(continued) 2.Type of Construction <br /> a. Length (ft.)= i�—� Number of bedrooms= <br /> �,Wood/Frame <br /> r <br /> b.Width(ft.)= 1f---- Number of garage stalls: ❑ Masonry <br /> Areas in square feet Attached= ❑ Metal <br /> c. Basement= l� � ❑ Pole Bldg. <br /> �„3 Detached= ❑ ICF <br /> d. 1S'Story = l�.'3� ❑ On-site Prefab <br /> e. 2"d Story= ❑ Off-site Prefab <br /> f. '/�Story = ❑ Other(please specify): <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 /> ❑ ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ Plan Review Fee <br /> ❑ Completed A lication Form <br /> � ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/z 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 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 <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 EscrowAgreement 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 <br /> of 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 Si nature: «�� /lJ. Date: �-1 l'"� <br /> 9 <br /> Owner's Signature: Date: <br /> Packet Last Updated: January 2015 <br /> Page 21 <br />