2017-00602 - new house - Laserfiche WebLink

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f � s • STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) " a.Length(ft.)= -/��,� Number of bedrooms= 5 2. Occupancy: E�C�`�� b.Width(ft.)= �� Number of garage stalis: 3. OccupantLoad: Areas in sauare feet Attached= � c.Basement= �' � � Detached= � 4. Type of Construction: ✓ d.1°�Story = �/`r�� .2"a Story= 5. Code Edi6on: �J ;P :�._ �3�- g.Total Area= __��(C� n REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed licabie ❑ Buildin Permit Escrow A reement and Fees ❑ Plan Review Fee ❑ Com leted A lication Form ❑ Pro osed Buildin Plans-2 full size sets to scale and 1 reduced 11 x 17 or 8'/:x 11 set ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements � ❑ Surve -2 full size,to scale meeGn ALL surve r uirements ❑ Hardcover Calculations ❑ Se tic S stem Certfication '�., ❑ Minnehaha Creek Watershed District(MCW D)Permit or Documentation from MCWD staqn no ermit is re uired ❑ Landsca e Walls and/or Retainin Wall Plans ❑ � Stormwater Pollution Prevention Plan SWPPP ❑ Access Permit ❑ Data Privacy Advisory Form APPLiCANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all informatlon required or requested by the Building Department; • Agrees to pay the Clty of Orono for engineering consultant review costs in excess of 5500; . Certifies that the information supplied is Uue and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no altemadve but to reject it until it is complete; . Acknowledges the Escrow Agreement is completed and signed; • Understands some or all of the information that you are asked to provide on this application is Gassfied by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is infoRnation which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information ls to annually update our records and records of other govemmental agencies required by law. If you refuse to supply the information,the application may not be issued. • Agrees that in the event that weather or other conditions preveM the compietfon of an as-buik survey at the tlme the Cert3ficate of Occupancy is requeated,a temporary CertNicate of Occupancy may be tssued upon receipt of a=10,000 eacrow to ensure completlon of the as-built survey and all site improvemerrts. ApplicanYs Signature: Date: S�3�1/ , Owner's Signature: Date: � - 3�' �� Last Updated: January 2016