2015-00719 - new structure - Laserfiche WebLink

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STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= Number of bedrooms= ❑Wood/Frame b.Width (ft.)= Number of garage stalis: ❑ Masonry � Areas in sauare feet Attached= ❑ Metal , ❑ Pole Bldg. : c. Basement= Detached= ❑ ICF d. 15'Story = ❑On-site Prefab e.2"d Story= ❑Off-site Prefab f. '/z Story = ` ❑Other(please specify): g.Total Area= REQU,IRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: NOt :,s� . ' a � . ` ' Enclosed A ticable ❑ ❑ Buildin Permit Escrow A reement and Fees 0 ❑ Plan Review Fee ❑ ❑ Com leted A lication Form ❑ ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/x 11 set ❑ ❑ Minnesota State Ener Co,tl Calculations a�rd^Mechanica!Code'Re uir�ements ❑ ' ❑ Surve —2 full size,to scale meetin ALL surve r uirement$ ❑ � • H2rdcover'Calculations ° • � � ❑ , $e tic S stem Certification ❑ 0 Minnehaha Cree Watershed District(MCWD)P�rmit or , . . � Documentation from.MCWD statin no ermit is re ired ` ❑ ❑ Landsca e Walls amd/6f R�t�inin all ans "'• . '' •` ❑ ❑ Stormwater Pollution Prevention Plan SWPPP ❑ ❑ Access Permit ❑ ❑ Data Priva Adviso Form ' � ° APPLICANT/OWNER ACKNOWL�DGEMENT: �� • Agrees to provide all information required or requested by the Building Department; . Agrees to pay the City of Orono for.engineering aonsultant,r�v,iew costs in exGess of$500; . . - • Certifies that the information supplied is true and correct to the best of his/her knd�irP�dge.' Thg applicant recognizes that they are solely responsible for submitting a complete applicatiQn being a�irare tHat:upon.failure to•do�so,•the staff has no altemative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is infonnation which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other govemmental agencies required by law. If you refuse to supply the information,the application may not be issued. . Agrees that in the evenf that weather or other condi#ions prevent tMe cnmpls#ion of an as-builE survey at the time the Certiflcate of Qccupancy is requested,a temparary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the a�-built survey and atl site'improvements. Applicant's Signatu� � ��/ Date: Owner's Signature: �//�i� Date: ��.'� J . . . , . . Packet Last Updated: January 2095 Page 21 �