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.STRUCTURE INFORMATION: <br /> � 7.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= 60 Number of bedrooms= 4 r/•GG-I� G�r��y 'j'/�/..../ <br /> / -Y/L(� <br /> b.Width(ft.)= 30 Number of garage stalls: ❑ onry������.���� <br /> Areas in spuare feet Attached= 2 � a� ,��e J �� <br /> e Bldg. <br /> c. Basement= 756 Detached= L <br /> d. 1S'Story = 1016 �e ��1 TIcLI� Z(��� � 1� � <br /> e. 2nd Story= 1312 <br /> i r <br /> f. '/�Story = e ' ): <br /> g.Total Area= 3084 <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for our ap lication to be rocessed: <br /> Not <br /> Enclosed A licable <br /> ❑ ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ O 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 YZ x 11 set <br /> ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ ❑ Surve —2 full size, to scale meetin ALL surve re uirements <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 /> ❑ GI Landsca e Walls and/or Retainin Wall Plans <br /> ❑ ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ ❑ Access Permit <br /> ❑ � Data Privac Adviso Form <br /> APPLICANTIOWNER 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 are <br /> solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no alternative 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 annuatly 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 /> Certiflcate of Occupancy is requested,a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 <br /> escrow to ensure completion of the as-built survey and all site improvements. <br /> ApplicanYs Signature: Markum J Olson Date: 01/15/2017 <br /> Owner's Signature: �� Date: <br /> Packet Last Updated: August 2015 <br /> Page 22 <br />