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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a. Length(ft)-- L- Number of bedrooms= CgWood!Frame <br /> ❑Masonry <br /> b.Width(ft.)= 18 - ` Number of garage stalls: ❑Metal <br /> Attached= ❑Pole Bldg. <br /> Areas in square feet Detached= ❑ICF <br /> ❑On-site Prefab <br /> c. Basement= ❑Off-site Prefab <br /> d. 1st Story = ❑Other(please specify): <br /> e.2nd Story= <br /> f. %Story = <br /> g. Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to beprocessed: <br /> Not <br /> Enclosed Applicable <br /> Ir ❑ Permit Application <br /> E' ❑ Proposed Building Plans <br /> ❑ ff- MN State Energy Code Calculations and Mechanical Code Requirements Form <br /> ❑ ar Survey(meeting all requirements) <br /> ❑ Stormwater Pollution Prevention Plan <br /> ❑ Hardcover Calculation(s) <br /> ❑ Se tic System Site Evaluation Report <br /> ❑ Access Permit <br /> ❑ Wetland Buffer improvement Plan <br /> ❑ Er Engineered Plans for Retaining Walls 4 feet or above <br /> ❑ ❑ Plan Review Fee <br /> ❑ ❑ Other <br /> APPLICANT ACKNOWLEDGEMENT: <br /> Agrees to provide all information required or requested by the Building Department: <br /> Agrees to pay the City of Orono for engineering consuitsnt reviser 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 <br /> are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative <br /> but to reject it until it is complete; <br /> Acknowledges 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 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 governmental agencies required by law. <br /> If you refuse to supply the information,the application may not be issued. <br /> Applicants Signature: Date: /1 03 20/D <br />