Laserfiche WebLink
STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction <br /> a. Length (ft.)= ��'�' Number of bedrooms= riJ�' <br /> �Wood/Frame <br /> b.Width (ft.)= 2�_ Number of garage stalls: W� ❑ Masonry <br /> Areas in spuare feet Attached= ❑ Metal <br /> ❑ Pole Bldg. <br /> c. Basement= 3 3 � Detached= <br /> [,� ICF C b��er�.�e;,,,�"� <br /> d. 1 S`Story = 3 :3 j�;, <br /> ❑On-site Prefab <br /> e.2`�Story= <br /> ❑Off-site Prefab <br /> f. '/2 Story = <br /> ❑Other(please specify): <br /> g.Total Area= �o}� <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for our ap lication to be processed: <br /> Not <br /> Enclosed A licable <br /> ❑ Permit A lication <br /> ❑ Pro osed Buildin Plans <br /> ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> ❑ Surve meetin all re uirements <br /> ❑ � , Stormwater Pollution Prevention Plan . <br /> � ❑ Hardcover Calculation s <br /> ❑ 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 /> ❑ � Minnehaha Creek Watershed District Permit s <br /> ❑ Plan Review Fae <br /> � ❑ Application Escrow&Agreement <br /> ❑ Other: <br /> APPLICANT/OWNER 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 /> • 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 <br /> of 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 other conditions prevent the comptetion of an as-built survey at the time the <br /> Certificate of Occupancy is requested, a femporary 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 /> C�. �`r �1��J� <br /> ApplicanYs Signature: � � Date: � <br /> Owner's Signature: � Date: `�/ � � �� 3 <br />