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r � � <br /> STRUCTURE INFORMATION: � <br /> 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction � � <br /> a. Length (ft.)= �s Number of bedrooms= � Wood/Frame <br /> b.Width (ft.)= 1�.� Number of garage stalls: ❑ Masonry <br /> Areas in spuare feet Attached = � ❑ Metal <br /> ❑ Pole Bldg. <br /> c. Basement= �.5� Detached = ❑ ICF <br /> d. 15�Story = ���� <br /> � ❑ On-site Prefab <br /> e. 2�d Story= <br /> ❑ Off-site Prefab <br /> f. 'h Story = �a5 �1'��` ❑ Other(please specify): <br /> g.Total Area= �Y 7� <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed Applicable <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'h x 11 set <br /> GY ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ Surve —2 full size,to scale meetin ALL surve requirements <br /> ❑ Hardcover Calculations <br /> ❑ ❑ Se tic 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 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 <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 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 <br /> of 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 �eceipt of a $10,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> ApplicanYs Signature: � � �� Date: ��� ���� <br /> Owner's Signature: Date: <br /> Packet Last Updated: January 2015 <br /> Page 21 <br />