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� , <br /> STRUCTURE INFORMATION: <br /> 1. Structure Dimensions I 1. Structure Dimensions (continued) I 2. Type of Construction I <br /> i � I <br /> I a. Length (ft.)= � �� Number of bedrooms= ; ❑Wood/Frame �i <br /> � �� � ❑ Masonry I <br /> b. Width (ft.)= Number of garage stalls: i ❑ Metal <br /> -. I Attached = i ❑ Pole Bldg. '' <br /> Areas in sauare feet � Detached = � ❑ ICF <br /> ; � ❑ On-site Prefab <br /> c. Basement= � �'� ❑Off-site Prefab <br /> 5c j ; �Other(please specify): <br /> d. 1 Story = , <br /> e. 2"d Story= I �t�,l �%�i�, ���^5 li� L� � <br /> f. YZ Story = <br /> g. Total Area= i 1 l���C �Ve( ' �� <br /> `� �'�0(�J 1(�,�j ��G� � <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 /> � � ❑ Permit A lication <br /> ❑ � Pro osed Buildin Plans <br /> ❑ � ❑ ' MN State Ener Code Calculations and Mechanical Code Re uirements Form � <br /> ❑ � Surve meetin all re uirements <br /> ❑ li ❑ Stormwater Pollution Prevention Plan I <br /> ❑ ❑ Hardcover Calculation(s <br /> ❑ ❑ � Se tic S stem Site Evaluation Re ort ' <br /> ❑ ❑ Access Permit <br /> ❑ ❑ I �Netland Buffer Im rovement Plan <br /> ❑ ❑ I En ineered Plans for Retainin Walls 4 feet or above <br /> j ❑ ❑ �, Plan Review Fee <br /> ❑ ❑ I 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 alternafive <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 i <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 /> � <br /> i,� /' l� � <br /> ApplicanYs Signature: �V � v�- Date: t— � � <br /> Last Updated: 6/22/2009 <br /> -20 - <br />