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STRUCTURE INFOftM�►�`ION: <br /> 1.Structure Dimensions . 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= . ��3 Number of bedrooms= � � <br /> ood/Frame <br /> b.Width (ft.)= �_ Number of garage stalls: ❑ Masonry <br /> Areas in sQuare feet Attached= 3 ❑ Metal <br /> c. Basement= � Detached= <br /> d. 1g�Story = �� City of Orono <br /> nd ����' 2750 Kelley Parkway <br /> e.2 Story= Orono MN 55356 9�2-249-4600 <br /> f. '/Z Story = <br /> g.Total Area= <br /> Receipt No: 3.011831 Sep 22, 2014 <br /> Gonyea Homes <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your applic �revious Balance: .00 <br /> Not Perrri ts <br /> Enclos A licable 2014-00771 195 Kintyre La 3,956.75 <br /> ❑ Permit A lication 101-32510 <br /> ❑ Pro osed Buildin Plans Building Permits <br /> ❑ MN State Ener Code Calculation: Permi ts <br /> ❑ Surve meetin all re uirements 2014-�00771 195 Kintyre La 300.00 <br /> ❑ Stormwater Pollution Prevention PI� 101-20802 <br /> ❑ HardcoverCalculation s Due to govts-State <br /> ❑ ❑ Se tic S stem Site Evaluation Re c Permi ts <br /> 0 ❑ Access Permit 2014-00771 195 Kintyre La 162.50 <br /> ❑ ❑ Wetland Buffer Im rovement Plan 101-34410 <br /> ❑ ❑ En ineered Plans for Retainin Wa Plan Check/Site Exam Fees <br /> ❑ ❑ Minnehaha Creek Watershed Distri ________________ <br /> ❑ Plan Review Fee Total: 4,419.25 <br /> ❑ ❑ Other: --------------- <br /> __---------- <br /> Check <br /> APPLICANT/OWNER ACKNOWLEDGEMENT: Check No: 14266 4,419.25 <br /> Payor: <br /> • Agrees to provide all information required or requested by the Builo Gonyea Homes <br /> Agrees to pay the City of Orono for engineering consultant revi� Total Appl ied: 4,419.25 <br /> � --------------- <br /> • Certifies that the information supplied is true and correct to the best�hange Tendered: .00 it they <br /> are solely responsible for submitting a complete application being aw -___=_=_�e===== native <br /> but to reject it until it is complete; 09/22/2U14 C9:02AM <br /> • Acknowledges the Escrow Agreement is completed and signed; <br /> • Understands some or all of the information that you are asked to provid� either <br /> private or confidential. Private data is information which generally canno� �ubject <br /> of the data. Confidential data is information which generally cannot be gir a. Our <br /> purpose and intended use of this information is to annually update our n encies <br /> required by law. If you refuse to supply the information,the application may <br /> • Agrees that in the event that weather or other conditions prevent ths cv���N�a��.,.� ..� �... ..a .....�........�y at the time the <br /> Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issuad upon rocefpt of a 510,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> ApplicanYs Signature: -- - Date: ���-f�y <br /> Owner's Signature: Date: ����-1)y <br /> Packet Last Updated: 04/19/°2013 <br /> Page 23 of 23 <br />