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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of ConsVuction <br /> a.Length(ft.)= Number of bedrooms= [�Wood/Frame <br /> ❑Masonry <br /> b.Width(ft.)= Number of garage stalls: ❑Metai <br /> Attached=� ❑ Pole Bidg. <br /> Areas in sauare feet Detached= ❑ ICF <br /> ❑On-site Prefab <br /> c.Basement= ❑Off-site Prefab <br /> d. 151 Story = ❑Other(please specify): <br /> e.2"d Story= <br /> f. Yz Story = <br /> g.Total Area= �3 y y s� �1' <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 /> ❑ Permit A lication <br /> C�f" ❑ Pro osed Buildin Plans <br /> ❑ C� MN State Ener Code Calculations and Mechanical Code R uirements Form <br /> � ❑ Surve meetin all r uirements <br /> ❑ l� Stormwater Pollution Prevention Plan <br /> G�' ❑ Hardcover Calculation s <br /> ❑ [rY Se tic S stem Site Evaluation Re ort <br /> ❑ I�' Access Permit <br /> ❑ Wetland Buffer Im rovement Plan <br /> ❑ 0' En ineered Plans for Retainin Walls 4 feet or above <br /> Q' ❑ Plan Review Fee <br /> ❑ ❑ Other <br /> APPLICANT 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 generalty 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 receipt of a 370,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> ApplicanYs Signature: � ' � Date: � ''� y'� � <br />