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STRUCTURE INFORMATION: <br /> 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction <br /> r <br /> a. Length (ft.)= � Number of bedrooms= � �Wood/Frame <br /> ❑ Masonry <br /> b.Width (ft.)= � Number of garage stalls: ❑ Metal <br /> Attached=� ❑ Pole Bldg. <br /> Areas in square feet Detached = ❑ ICF <br /> ❑ On-site Prefab <br /> c. Basement= ?b g ❑ Off-site Prefab <br /> d. 1S`Story = ��2`"L ❑ Other(please specify): <br /> e. 2nd StOry= "'' <br /> f. 'h 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 /> Enclos A licable <br /> ❑ Permit A lication <br /> ❑ Pro osed Buildin Plans <br /> ❑ L�- MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> 0 .B� Surve meetin all re uirements <br /> ❑ p� Stormwater Pollution Prevention Plan <br /> ❑ �- Hardcover Calculation s <br /> ❑ ,� Se tic S stem Site Evatuation Re ort <br /> ❑ Access Permit <br /> ❑ ,0"" Wetland Buffer Im rovement Plan <br /> ❑ .B— En ineered Plans for Retainin Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ ❑ Other <br /> APPLICANT ACKNOWLEDGEMENT: <br /> Agrees to provide atl 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 <br /> are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative <br /> but to reject it until it is complete; <br /> Acknowledges the Escrow Agreement is compfeted and signed; <br /> Some or all of the information that you are asked to provide on this application is classified by State law as either private or <br /> confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. <br /> Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this information is to annually update our records and records of other governmental agencies required by law. <br /> If you refuse to supply the information,tf e application may not be issued. <br /> ApplicanYs Signature: Date: ���� � � <br />