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STRUCTURE INFORMATION: <br /> 9.Structure Dimensions 1.Structure Dimensiona(contlnued) 2.Type of Construction <br /> a. Length(ft.)= �-�- Number of bedrooms=� �Wood/Frame <br /> b.Width(ft.)= ,� Number of garage stalis: ❑Masonry <br /> Areas in sauare feet Attached=� ❑Metal <br /> c. Basement= �� Detached= ❑Pole Bldg. <br /> ❑ICF <br /> d. 1�Story = ���_ <br /> ❑On-site Prefab <br /> e.2"�Story= ❑Off-site Prefab <br /> f. '/:Story = <br /> ❑Other(please specify): <br /> g.Total Area= ��� <br /> �- �-�R�} faiPt{'wvt�Sine� <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> tll;� _`u�`'�.�. : ���" � �-T.:r',�'nz t�F*as�,� t� .a•:i �' t__+';�"��'"'`'�.��1�^,. <br /> 't�i�'� ...�,,.�-UK�J�S`�.s��+��� ��''�:sn�� �m��r':°�-.: <br /> � ❑ Permit A lica�on <br /> � ❑ Pro osed Buildin Plans <br /> � MN State Ener Code Calculations and Mechanical Code Re uirements Form <br /> � ❑ Surve meetin all re uirements <br /> 0 �Q Stormwater Pollution PrevenUon Plan <br /> ]� ❑ Hardcover CalculaUon s <br /> 0 �( Se tic S stem Site Evaluatlon Re ort <br /> 0 Access PeRnit <br /> � Wetland Buffer Im rovement Plan <br /> ❑ � En ineered Plans for Retainin Walls 4 feet or above <br /> ❑ APPi �e ❑ Minnehaha Creek Watershed Dis�ict Permit s <br /> � ❑ Plan Review Fee <br /> � Other. <br /> APPLICANT/OWNER ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Building Department; <br /> • Agrees to pay the Clty of Orono for engineering consuitant review costs in excess of$500; <br /> • Certifles that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they <br /> are solely responsible for submitting a complete applica�on.being aware that upon failure to do so, the staff has no altemative <br /> but to reject it until it is complete; <br /> • Acknowledges the Escrow Agreement is completed and signed; <br /> • Understands some or all of the infortnation that you are asked to provide on this appiication is classified by State law as either <br /> private or confidential. Private data is informa�on which generally cannot be given to the public but can be given to the subject <br /> of the data. ConfidenUal data is infoRnation which generally cannot be given to either the public or the subject of the data. Our <br /> purpose and intended use of this informaUon is to annuatly update our records and records of other govemmentat agenctes <br /> required by law. If you refuse to supply the informa�on,the applicaUon may not be issued. <br /> ApplicanYs Signature: � ��►�Date: ��� —1� <br /> Owner's Signature: Date: ��G//� <br /> Packet Last Updated: 19/2013 <br /> Page 23 of 23 <br />