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a <br /> ♦ <br /> TRUCTURE INFORMATION: <br /> .Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= Number of bedrooms= ❑Wood/Frame <br /> ❑ Masonry <br /> b.Width(ft.)= Number of garage stalis: ❑ Metal <br /> Attached= ❑ Pole Bldg. <br /> Areas in sauare feet Detached= ❑ ICF <br /> ❑On-site Prefab <br /> c.Basement= ❑ Off-site Prefab <br /> d. 1gt Story = ❑ Other(please specify): <br /> e.2"d Story= <br /> f. '/Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for our a lication to be rocessed: <br /> °Not <br /> ' fnclosed licable <br /> � ❑ Permit A lication <br /> � ❑ Pro osed Buildin Plans <br /> � 0 MN State Ene Code Calculations and Mechanical Code R uirements Form <br /> � ❑ Surve meetin all r uirements <br /> � � Stormwater Pollution Prevention Plan <br /> � ❑ Hardcover Calculation s <br /> � ❑ Se tic S stem Site Evaluation Re ort <br /> � ❑ Access Permit <br /> � � Wetland Buffer Im rovement Plan <br /> � ❑ 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 5500; <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 altemative <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 <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 govemmental agencies required by law. <br /> If you refuse to supply the information,the application may not be issued. <br /> ApplicanYs Signature: � Date: � <br /> • <br /> Last Updated: 5/21/2009 <br /> -21 - <br />