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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construc�on <br /> a. Length(ft.)= Number of bedrooms= ❑Wood/Frame <br /> ❑Masonry <br /> b.Width(ft.)= Number of garage stails: ❑ Metal <br /> Attached= ❑ Pole Bldg. <br /> Areas in sauare feet Detached= ❑ ICF <br /> ❑On-site Prefab <br /> c. Basement= ❑OfF site Prefab <br /> d. 1�`Story = <br /> ❑Other(please speciy): <br /> e.2nd Story= <br /> f. '/z Story = <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for our a lication to be rocessed: <br /> Not <br /> Enciosed licable <br /> ❑ Permit lication <br /> ❑ Pro osed Buildin Plans <br /> ❑ MN State Ener Code Calculations and Mechanical Code Re uinements Form <br /> O Surve �etin all re uinements <br /> ❑ Stortnwater Pollution Prevention Plan <br /> ❑ Hardcover Calculation s <br /> ❑ Se ic S stem Site Evaluation Re rt <br /> ❑ Access Permit <br /> ❑ 1� Wetland Buffer I rovement Plan <br /> ❑ En ineered Plans for Retainin Walls 4 feet or above <br /> ❑ Plan Review Fee <br /> ❑ ❑ Other <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Building Department; <br /> . Agr+ees to pay the City of Orono for engineering consultant review cos�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 soley responsible for submitting a complete application being aware that upon failure to do so, the stafF has no altemative <br /> but to reject it until it is complete; <br /> • Acknowledges the Escrow Agreement is completed and signed; <br /> • Some or all of the information that you are asked to provide on this application is classified by State law as either private or <br /> confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. <br /> Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this infomiation is to annualy update our records and records of other governmental agencies required by law. <br /> If you refuse to supply the information,the application may not be issued. <br /> ApplicanYs Signature: Date: � � i <br /> Last Updated: 9l29/2009 <br /> - 18- <br />