Laserfiche WebLink
4 . 1 <br /> STRUCTURE INFORMATION: <br /> } <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a.Length(ft.)= R z- (r, t Number of bedrooms= $ Wood/Frame 1 <br /> b.Width(ft.)= 131 b `g Number of garage stalls: ❑Masonry <br /> Areas in square feet Attached= T <br /> [I] metal <br /> ❑Pole Bldg. <br /> c. Basement= 2597 Detached= 4 ❑ ICF <br /> d. 1St Story = '31 O <br /> ❑On-site Prefab t <br /> e.2nd Story= 1.1,4- ❑Off-site Prefab I <br /> f. %a Story = J.I-Ile, El Other(please specify): g <br /> g.Total Area= G 2-113 • <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed Applicable <br /> K 0 Building Permit Escrow Agreement and Fees <br /> X 0 Plan Review Fee 11 <br /> iZ 0 Completed Application Form 4 <br /> X 0 Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8%x 11 set <br /> lit 0 Minnesota State Energy Code Calculations and Mechanical Code Requirements <br /> X 0 Survey—2 full size,to scale(meeting ALL survey requirements) <br /> lit 0 Hardcover Calculations , <br /> ❑ 0 Septic System Certification <br /> II <br /> 0 0 Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD stating no permit is required <br /> ❑ 0 Landscape Walls and/or Retaining Wall Plans <br /> ❑ Stormwater Pollution Prevention Plan(SWPPP) g <br /> ❑ Access Permit <br /> X 0 Data Privacy Advisory Form <br /> APPLICANT/OWNER ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Building Department; <br /> 1 <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 application is classified by State law as either <br /> private or confidential. Private data id 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 /> . <br /> p— o <br /> pplicant'sSignature✓-�-- —/, Date: ,–Z�--ZO/C0 <br /> )wner's Signature: ,��...�� ..--e— Date: -'2 4' 7,6 <br /> RECEIVED <br /> JUN 29201n <br /> Packet Last Updated: August 2015 <br /> Page 22 CITY OF ORONO <br />