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STRUGTURE INFORMATION: <br /> 1. Structure Dimensions 1. Structure Dimensions (continued) <br /> a. Length(ft.)= Number of bedrooms= 2. Occupancy: -�"��J r <br /> b.Width(ft.)= Number of garage stalls: <br /> 3. Occupant Load: <br /> Areas in sauare fPet Attached= <br /> c. Basement= Detached= 4. Type of Construcion: ��l(i <br /> d. 151 Story = „ ,�a <br /> e,2"d Story= 5. Code Edition: ������ ���� <br /> f. '/z Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclo�ed 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'/z x 11 set <br /> p ❑ 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 /> ❑ O 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 /> p ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ ❑ Access Permit <br /> ❑ ❑ Data Privac Adviso Form <br /> APPLICANT/OWNER 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 are <br /> solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no altemative but to <br /> reject it until it is complete; <br /> . Acknowledges the Escrow Agreement is completed and signed; <br /> s 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 /> . Agrees that in the event that weather or other conditions prevent the completfon of an as-built survey at the ttme the <br /> Certlficat� of Occupancy Is requested, a tempor�ry Cert(ficate of Occupancy may be issued upon receipt ot a;10,000 <br /> escrow to ensure completion of the as-bullt survey and all site improvements. <br /> � <br /> ApplicanYs Signatur . ^� Date: � Z� <br /> ' _ i :� / <br /> Owner'�Signature: � -��� �' /'.--1 Date: � � �/ � <br /> � �������v <br /> / <br /> Packet Last Updated: January 2096 <br /> Page 22 <br />