Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
. . , <br /> �, f <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensio�s 1.Structure Dimensions(co�tinued) 2.Type of Construction <br /> a.Length(ft.)= 7� Number of bedrooms=�_ <br /> �/ �Wood/Frame <br /> b.Width(ft.)= o�s'/�- Number of garage stalls: ❑Masonry <br /> Areas in square feet Attached= 2 ❑Meta) <br /> ❑Pole Bldg. <br /> c.Basement= �GQZ Detached= <br /> d. 1"Story = <br /> 9�l� ❑icF <br /> / p On-site Prefab <br /> 8 Znd$tOfy= / Zz <br /> ❑Off-site Prefab <br /> f. %Story = <br /> ❑Other(please specify): <br /> g.Total Area= )Z <br /> REqUIRED SUBMITTALS: <br /> Ail of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed A Iicable <br /> .�1 ❑ Permit A lication <br /> .� ❑ Pro osed Buildin Plans <br /> �- ❑ MN State Ener Code Calcutations and Mechanicai Code Re uirements Form <br /> O Surve meetin all re uirements <br /> ❑ ❑ Stormwater Pollution Prevention Plan <br /> ,�1. ❑ Hardcover Calculation s <br /> O Q Se tic S stem Site Evatuation Re oR <br /> ❑ Access Permit <br /> 0 Wetland Buffer Im rovement Plan <br /> ❑ ;� En ineered Plans for Retainin Walis 4 feet or above <br /> � ❑ Plan Review Fee <br /> ❑ ❑ Other. <br /> APPLICANTIOWNER ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Building Depa�tment; <br /> • Agrees to pay the Clty of Orono tor engineering consultant revlew costs In excess of 5500; <br /> • Certifies that the information supplied is true and correct to the best of hfs/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 confldential. Private data fs 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 /> Certiflcate of Occupancy is requested,a temporary Certiflcate of Occupancy may be issued upon receipt of a 510,000 <br /> escrow to ensure completion of the as-buift survey and all site improvements. <br /> ApplicanYs Signatur : � � 1 � �`' Date: f �—�� <br /> Owner's Signature: Date: / — a���/-3 <br />