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STRUCTURE INFORMATION: <br /> 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft.)= b�� Number of bedrooms= [$��/�lood/Frame <br /> � ; , „ <br /> b.Width(ft.)= � �" Number of garage stalls: ❑ Masonry <br /> ❑ Metal <br /> Areas in sauare feet Attached= <br /> _ ❑ Pole Bldg. <br /> ;' <br /> c. Basement= ^� ��" Detached = � ICF <br /> d. 151 Story = �� ❑ On-site Prefab <br /> e.2nd Story= N i �f ❑ Off-site Prefab <br /> f. Y2 Story = �' � �� ❑ Other(please specify): <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 <br /> Enclosed A licable <br /> ❑ ❑ Buildin Permit Escrow A reement and Fees <br /> ❑ ❑ Plan Review Fee <br /> ❑ � Com leted A lication Form <br /> ❑ ❑ Pro osed Buildin Plans—2 fult size sets,to scale and 1 reduced 11 x 17 or 8'/z x 11 set <br /> ❑ ❑ 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 e Walls and/or Retainin Wall Plans <br /> ❑ ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ ❑ Access Permit <br /> ❑ ❑ Data Privacy Advisory Form <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 completion 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-b ' rvey and all site improvements. <br /> � ` oate: �// �// � �ECENED <br /> ApplicanYs Signature: -- <br /> Owner's Signature: Date: AI If; �� fl 7ni� <br /> Last Updated: January 2015 - <br /> CITY OF ORONO <br />