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STRUCTURE INFORMATION: <br /> 1. Structure Dimensions i 1. Structure Dimensions (continued) i 2. Type of Construction <br /> � <br /> a. Length (ft.)= i Number of bedrooms= I �Wood/Frame <br /> Masonry <br /> b. Width (ft.)= Number of garage stalls: ❑ Metal <br /> I Attached = i ❑ Pole Bldg. � <br /> Areas in square feet I Detached = ❑ ICF <br /> � � ❑ On-site Prefab I <br /> c. Basement= �� ' ❑ Off-site Prefab <br /> d. 15t Story = � ❑ Other(piease specify): � <br /> e. 2nd Story= I <br /> f. '/z Story = <br /> g. Total Area= <br /> � <br /> I <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> N ot <br /> Enclosed A licable <br /> ❑ ❑ Permit A lication <br /> ❑ ❑ i Pro osed Buildin Plans <br /> ❑ ❑ ! MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> O ❑ I Surve meetin all re uirements <br /> ❑ � ❑ ' Stormwater Pollution Prevention Plan <br /> ❑ ❑ Hardcover Calculation s � <br /> ❑ ❑ I Se tic S stem Site Evaluation Re ort ' <br /> ❑ ❑ Access Permit <br /> ❑ ❑ Wetland Buffer Im rovement Plan <br /> ❑ � , En ineered Plans for Retainin Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ i ❑ 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 appfication 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. � <br /> If you refuse to supply the information, the application may not be issued. <br /> i <br /> ApplicanYs Signature: Date: <br /> Last Updated: 6/22/2009 <br /> -20 - <br />