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REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed licable <br /> ❑ O Buildin Permit Escrow A reement and Fees ' v� r'i y - <br /> ❑ Plan Review Fee ��U <br /> ❑ Com leted lication Fo m <br /> ❑ Pro osed Pool or Hot Tub Plans-2 sets, full-size, to scale <br /> ❑ Surve -2 full size, to scale meetin ALL surve re uirements <br /> ❑ Hardcover Information <br /> ❑ �' Se tic S stem Certification <br /> ❑ ❑ Minnehaha Creek Watershed District(MCWD) Permit or ����y1�.��ns�- <br /> documentation from MCWD statin no ermit is re uired <br /> ❑ Landsca e Walls and/or Retainin Wall Plans <br /> � Stormwater Pollution Prevention Plan �� <br /> G�" ❑ Data Privac Adviso Form <br /> ❑ ❑ <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Planning&Building Departments; <br /> • Understands, if applicable, an as-built survey and as-built hardcover cover calculations, are required to be submitted after the <br /> project is complete(including final grading and landscaping)prior to refunding the escrow; <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 after�ative but to <br /> reject it until it is complete; <br /> • Some or all of the information that you are asked to provide on this application is dassified by State law as either private or <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 governmenta{agencies required by law. If <br /> you refuse to supply the information,the permit may not be issued, <br /> ApplicanYs Signature: �� Date; Z jZl�� � <br /> Owner's Signature Date: 2•15.2017 <br /> Packet Last Updafed: Apri12016 <br /> Page 23 <br />