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,�1 <br /> 3 + <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) <br /> a. Length (ft.)= Number of bedrooms= 2. Occupancy: ���" / <br /> b.Width (ft.)= Number of garage stalls: 11 � <br /> � � �'3. Occupant Load: Q5i �-��'oL'�ld� <br /> Areas in square feet Attached = ' 1� <br /> c. Basement= Delac ed� �l 4. Type of Construction: �Y��` <br /> d. 1 St Sto = � � / <br /> e.2nd gt ry- � ��?�' �;��� 5. Code Edition:��0(� ��� <br /> f. '/z Story = � � � � <br /> g.Total Area= �;� <br /> � <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> N ot <br /> Enclosed Ap 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'/�x 1 1 set <br /> ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements ' <br /> ❑ ❑ Survey-2 full size,to scale(meeting ALL survey requirements) <br /> ❑ Hardcover Calculations <br /> ❑ Septic S stem Certification <br /> ❑ 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 /> ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ Access Permit <br /> ❑ ❑ Data Privacy Advisory 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$500; <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 alternative but to <br /> 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 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 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 /> Applicant's Signature: Date: 7/14/2016 <br /> Owner's Signature: �-- -;�� �1�- -� Date: 7`�ylzu�6 <br /> Last Updated: January 2E716 <br /> L <br />