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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1. Structure Dimensions(continued) <br /> a. Length(ft.)= Number of bedrooms= 2. Occupancy: �C �/ <br /> b.Width(ft.)= Number of garage stalls: <br /> 3. Occupant Load: <br /> Areas in sauare feet Attached= <br /> c.Basement= Detached= 4. Type of Construcion: �� <br /> d. 1 S'Story = ���J � `�l �� <br /> e.2nd Story= 5. Code Edition: � <br /> f. '/�Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for our a plication to be processed: <br /> Not <br /> Enclosed licable <br /> ❑ D Buildin Permit Escrow A reement and Fees <br /> ❑ ❑ Plan Review Fee <br /> O O Com leted lication Form <br /> ❑ ❑ Pro osed Buildin Plans—2 fuil size sets to scale and 1 reduced 11 x 17 or 8%z x 11 set <br /> p ❑ Minnesota State Ene Code Calculations and Mechanical Code Re uirements <br /> ❑ ❑ Surve —2 full size,to scale meetin ALL sunre re uirements <br /> ❑ ❑ Hardcover Calculations <br /> ❑ ❑ Se tic S tem Certification <br /> ❑ ❑ Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD statin no rmit is re uired <br /> ❑ ❑ Landsca e Walls and/or Retainin Wall Plans <br /> ❑ ❑ Landsca e Plan <br /> ❑ ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ ❑ Access Permit <br /> O ❑ 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 Clty 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 are <br /> solely responsible for submitting a complete application being aware that upon failure to do so,the stafF has no altemative but to <br /> 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 of <br /> 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 /> . Agroes that In the event that weather or other conditions prevent the completion of an as-built survey at the time the <br /> ' Certlflcate of Occupancy is requested, a demporary Cettlflcate of Occupancy may be Issued upon recefpt of a;10,000 <br /> escrow to ensure completlon of the as-bullt survey and all slte Improvements. <br /> ApplicanYs signature: �ate: �=Z3 �� 7 <br /> Owner's Signature: Date: <br /> Packet Last Updated: January 2016 <br /> Page 22 <br />