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STRUCTURE IHFORMATION: <br /> 1. Structure Dimensfons 1.Structure Dimensions(continued) <br /> a. Length(ft.)= Number of bedrooms= 2. Occupancy: <br /> b.Width(ft.)= Number of garage stalls: <br /> 3. Occupant Load: <br /> Areas in sauare feet Attached= <br /> c. Basement= Detached= 4. Type of Construcion: <br /> d. 15i Story = <br /> e.2"d Story= 5. Code Edition: <br /> f. Yz Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> Afl 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 Y�x 11 set <br /> ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ ❑ Surve —2 full size,to scale meetin ALL surve re uirements <br /> ❑ ❑ Hardcover Calculations <br /> ❑ ❑ Se tic S stem Certification <br /> p ❑ 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 /> ❑ � Landsca e Plan <br /> ❑ ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ ❑ Access Permit <br /> ❑ ❑ Data Privac Adviso Form <br /> APPLICANT/OWNER ACKNOWLEDGEMEIVT: <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 govemmental agencies <br /> required by law. If you refuse to supply the information,the application may not be issued. <br /> . �grees lhat in the event tha4 weather or other conditions prevent the completion of an as-built surv�y �t the time the <br /> Certificate of Occupancy is reque�ted, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 <br /> escrow to ensure completion of the as-bullt�urvey and all site improvements. <br /> ApplicanYs Signature: Date: <br /> Owner'� Signature: Date: <br /> Packet Last Updated: January 2016 <br /> Page 22 <br />