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r <br /> S1�UCTURE INFORMATION: <br /> 1.Structure Dimensions 1. Structure Dimensions(continued) <br /> . <br /> a. Length (ft.)= � Number of bedrooms= � 2. Occupancy: <br /> / <br /> b.Width (ft.)= � � Number of garage stalls: � <br /> 3. Occupant Load: <br /> Areas in square feet Attached = <br /> � vJL_ <br /> c. Basement= Detached= �9U w J 4. Type of Construction: ���� �^f <br /> d. 1S'Story = ��� � nu � t,4.�e.-l-�;;-• <br /> e. 2�d StOry = �',�t� G� 5. Code Edition: <br /> , Sc.�e.�. �-w�� <br /> f. '/z Story = _ f <br /> �v:{ o ��c �� 3-,� �.cn�,�_ <br /> g. Total Area= � ' �'� � � <br /> Ca V �r- r,v e�,�,.c.,. <br /> p� <br /> RE(�UIRED 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 full size sets,to scale and 1 reduced 11 x 17 or 8 Yz 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 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 apptication 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 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 other conditions prevent the completion of an as-built survey at the time the <br /> Certificate of Occupancy is requested, a temporary 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 /> Applicant's Signature: Date: �'� / '�/� <br /> �j% 'i � % �• <br /> Owner's Signature: �--'f"....,�. -� '' ``.� Date: ' <�� C°( - <br /> Last Updafed: January 201 d Cj� �/�� r � <br /> / <br />