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. � <br /> � <br /> STRUCTURE INFORMATION: <br /> , 1. Structure Dimensions L Structure Dimensions(continued) i 2.Type of Construction i <br /> � <br /> a. Length (ft.)= 2 S I Number of bedrooms= ',� �Wood/Frame <br /> � � ❑ Masonry <br /> b.Width (ft.)= J3 I Number of garage stalls: ❑ Metal <br /> � Attached = ❑ Pofe Bldg. <br /> Areas in square feet i Detached = ❑ ICF <br /> � ❑ On-site Prefab <br /> c. Basement= � <br /> I ❑ Off-site Prefab <br /> d. 1S`Story = I � ❑ Other(please specify)� <br /> e. 2ntl Story= � <br /> i <br /> f. '/z Story = <br /> g. Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not I <br /> Enclosed Ap licable <br /> ❑ ' Permit A lication <br /> � R[ ❑ � Pro osed Buildin Plans � <br /> ❑ � I MN State Ener Code Calculations and Mechanical Code Re uirements Form ' <br /> ❑ : Surve meetin all re uirements <br /> ❑ 1� ' Stormwater Pollution Prevention Plan <br /> ❑ Hardcover Calculation(s) <br /> ❑ I Se tic S stem Site Evaluation Re ort <br /> ❑ I Access Permit <br /> ❑ Wetland Buffer Im rovement Plan i <br /> � I En ineered Plans for Retainin Walls 4 feet or above <br /> L ❑ ❑ , Plan Review Fee i <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 /> • Some or all of the information that you are asked to provide on this application is classified by State law as either private or i <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 information is to annually update our records and records of other governmental agencies required by law. I <br /> If you refuse to supply the information, the application may not be issued. � <br /> i <br /> Applicant's Signature: Date: � � � <br /> �1 <br /> Last Updated: 6/22/2009 <br /> -20 - <br />