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STRUCTURE INFORMATION: <br /> � 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length (ft.)= �� � Number of bedrooms= � <br />• �Wood/Frame <br /> b.Width (ft.)= / � � Number of garage stalls: �,. ❑ Masonry <br /> Areas in square feet Attached =11(� <br /> �l � ❑ Metal <br /> ❑ Pole Bldg. <br /> c. Basement= Detached =,1� ❑ ICF <br /> d. 151 Story = � � f <br /> ❑ On-site Prefab <br /> e. 2nd Story = <br /> ❑ Off-site Prefab <br /> f. Yz Story = <br /> ❑ Other(please specify): <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 /> Enclosed A licable <br /> 0 ❑ Buildin Permit Escrow A reement and Fees <br /> ;E7'" ❑ 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 Yz x 11 set <br /> � ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> _-E3�' ❑ Surve —2 full size, to scale meetin ALL surve re uirements <br /> _-� ❑ Hardcover Calculations <br /> ❑ Se tic S stem Certification <br /> 0" ❑ 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 Pians <br />• ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ,_0' ❑ 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$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 /> � 1 � � � <br /> ApplicanYs Signature: � �t� � �c�t�•. ���� � Date: �� �� � <br /> � <br />•Owner's Signature: - '�' � '��- Date: <br /> Packet Last Updated: August 2015 <br /> Page 22 <br />