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S'�RUCTI�RE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= 92� Number of bedrooms= 4 <br /> �Wood!Frame <br /> b.Width(ft.)= 99� Number of garage stalis: 2 ❑Masonry <br /> Areas in sauare feet Attached= 2 StBIIS ❑Metal <br /> ❑ Pole Bldg. <br /> c. Basement= N�p` Detached= � ❑ ICF <br /> d. 15t Story = 3,856 SF Total Area includes 902 <br /> ❑On-site Prefab <br /> e.2^d Story= 1,439 SF SF attached garage <br /> NON-HAB ❑Off-site Prefab <br /> f. '/z Story = 700 SF MEzz <br /> ❑Other(piease specify): <br /> g.Total Area= 5,995 SF <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 /> O O Buildin Permit Escrow A reement and Fees <br /> ❑ ❑ 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'h x 11 set <br /> ❑ 0 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 /> ❑ ❑ Landsca 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 Gassified 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 /> • Agrees that in the>event that weather or o�er c�nditions prevent the completic�n of an as-bullt survey at the tlme th� <br /> Cert�cate of�ccupancy is requested,a;temporary Certi�cate of Occupancy may be,issued upan rece�p#af a$10,000 <br /> escrow#o ensure completian of the as-built survey and all site improvements. <br /> Applicant's Signature: Date: <br /> Owner's Signature: ���,� � Date: Mav 19, 2017 <br /> Packet Last Updated: August 2015 <br /> Page 22 <br />