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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> � � Wood/Frame <br /> a. Length (ft.)= � Number of bedrooms= � <br /> � ❑ Masonry <br /> b.Width(ft.)= �QS7 Number of gar ge stalls: ❑ Metal <br /> Attached =� ❑ Pole Bldg. <br /> Areas in square feet Detached= ❑ ICF <br /> ❑ On-site Prefab <br /> c. Basement= {� ❑Off-site Prefab <br /> d. 15`Story = �7q� ,—, _ . . _ <br /> e. 2nd Story= ,23 99 �� <br /> ;�,���,�. � --_ . , <br /> Z , <br /> �, � <br /> f. / StorY = �.�i! (� l? �[,?.-}l1i't� <br /> g. TotalArea- (�D Dan@Stonewood.com <br /> 7�U7 �Vayzata Bc�ulcvarcl <br /> REQUIRED SUBMITTALS: Minneapolis, fV1N 5542(, <br /> All ofthe information must be submitted in orderforyou ,ti,;�,,,�,,�,�.� � � �,�� , ;,,�,;<,�;,- <br /> Not www.STONEWOOD.com <br /> Enclosed Applicable <br /> ❑ Permit A lication <br /> 0' ❑ Pro osed Buildin Plans <br /> 8 ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> .ei ❑ Surve meetin all re uirements) <br /> .0' ❑ Stormwater Pollution Prevention Plan <br /> -0 ❑ Hardcover Calculation s <br /> .� ❑ Se tic S stem Site Evaluation Re ort <br /> ❑ 0' Access Permit <br /> ❑ ,,0'' Wetland Buffer Im rovement Plan <br /> ❑ 8' En ineered Plans for Retainin Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ ❑ 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 alternative <br /> but to 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 <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 Signature: i��,�� ��� Date: ¢S`��C�L� �l� <br /> .� <br /> Packet Last Updated: 10-20-2011 <br /> -21 - <br />