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� <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure QimensiQns(continued) 2.Type of Construction <br /> a. Length(ft.)= . : � Number of bedrooms= �Wood/Frame <br /> ❑Maso.n.ry <br /> b.Width(ft.)= �t�"� Number of garage stalls: ❑Meta! <br /> Attached= ❑Pole Bldg. <br /> Areas in sauare feet Detached= ❑ ICF <br /> ❑O�►-site Pretab <br /> c. Basement= ❑Off-site Prefab <br /> d. 1�Story = ..1 '�� <br /> �Other(please specify): <br /> e.2"°Story= <br /> f. '/:Story = <br /> g.Total Area= �y�' <br /> REQUIRED SUBMITTALS: <br /> All of the infonnation must be submitted in order for your anplication to be processed: <br /> Nat <br /> Enclosed A iicable <br /> � ❑ Pei*=:i! licatioa <br /> ❑ 0 Pro osed Buifdin Plans <br /> ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> ❑ ❑ Surve �ti ali r uirerri�rtts <br /> ❑ ❑ Stormwater Poftution Prevention Pfan <br /> ❑ � Hardcover Calculation s <br /> 0 ❑ Se tic S stem Site�valuation Re ort <br /> ❑ ❑ Access Permit <br /> ❑ ❑ Wetland Buffer Im rovement Plan <br /> ❑ ❑ En ineered Plans for Retainin Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ ❑ Qther <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all infoRnation 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 tinforsnafson supp4ied is true and correct to the best of hts/her know4edge. T4�e appl'scant recagnizes that they <br /> are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no altemative <br /> b�t to reject ii until it is complete; <br /> • Acknowtedges the Escrow Agreement is completed and signed; <br /> • Some or all of the information that you are asked to provide on this application is classified 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 give�to either the public or the subject of the data. Our purpose and <br /> intended use of ttlis information is to annually update our records and records of other govemmental agencies required by law. <br /> If you refuse to supply the information,the application may not be issued. <br /> ApplicanYs Signature: Date: <br /> Last Updated: 9/29/2009 <br /> - 18- <br />