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STRUCT,URE INFORMATION: <br /> 1�,Struct:;re Dimensions 1.Structure Dimensions(continued) 2.Type of Construction � `�� <br /> •� /��, <br /> a. Length(ft.)= �� Number of bedrooms=�_ <br /> �� [� d Frame Q�G✓�aKCy ��"\C~� <br /> b.Width(ft.)= Number of garage stalls: ❑M so � <br /> Areas in sauare feet Attached= � �Me ���/f✓ l �J�C <br /> c. Basement= 25�D ❑Pol Bldg. <br /> Detached= � ❑ ICF <br /> d. 1 u Story = �-1 S� <br /> ❑O -s�e Prefab <br /> e.2"d Story= <br /> ,7�� ❑O -sit Prefab <br /> f. YZ Story = <br /> ❑ ther( ase specify): <br /> g.Total Area= 5��Sv <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your a plication to be rocessed: <br /> Not <br /> Enclosed A licabte <br /> ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ Plan Review Fee <br /> ❑ Com leted A lication Form <br /> ❑ C,�' Pro osed Buildin Plans—2 full size sets to scale and 1 reduced 11 x 17 or 8 Y x 11 set <br /> ❑ Minnesota State Ener Code Calculations and Mechanical Code R uirements <br /> ❑ �' Surve —2 full size,to scale meetin ALL suroe re uirements <br /> ❑ Hardcover Calculations <br /> O Se tic S stem Certification <br /> ❑ Minnehaha Creek Watershed District(MCWD) Permit or <br /> Documentation from MCWD statin no ermit is r uired <br /> ❑ Landsca e Walls and/or Retainin Wall Plans <br /> ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ Access Permit <br /> O 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 enginee�ng consultant review costs in excess of$500; <br /> • Certifies that the information supplied is true and cor�ect 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 pubfic 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 annualfy 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 oi a $10,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> � / �/Applicant's Signature: � Date: �/� � <br /> Owner's Signature: � �"� Date: ��2`��G <br /> �� <br /> �� 7�� �6 <br /> Packet Last Updated: August 20f5 <br /> Page 22 <br />