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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction <br /> a.Length($,)= Number of bedrooms= ❑Wood/Freme <br /> b.Width(ft.)= Number of garage stalls: ❑Masonry <br /> Areas in souars feet Attached ❑Metal <br /> ❑Pole Bldg. <br /> Q Basementz Detached_ ❑ICF <br /> d.1 o Story= ❑On-site Prefab <br /> e.2"tl Story= ❑Oft-site Prefab <br /> f. %Story = ❑Other(pleas spedty): <br /> g.Total Area= <br /> l <br /> REQUIRED SUBMITTALS: <br /> All of the Information must be submitted In order for your application to be rocessed: <br /> Not <br /> Enclosed Applicable <br /> Permit Application <br /> Proposed Bulkilng Plans <br /> MN State EneW Code Calculations andcal Code uire nts Form <br /> Su mestin ail ulrements <br /> Stormwater Pollution Prevention Plan <br /> Hardcover Calculation(s) <br /> Septic System Site Evaluation Report <br /> Access Permit <br /> Wetland Buffer linproverrent Plan <br /> F.n Ineered Plana for Retaining Walla 4 feet or sieve <br /> Minnehate Creek Watershed District Permit(s) <br /> Plan Review Fee <br /> Application Escrow&Agreement <br /> Other. <br /> APPLICANT/OWNER ACKNOWLEDGEMENT: <br /> Agrees to provide all Information required or requested by the Building Department; <br /> Agrees to pay the City of Orono for engineering consultant review costs In excess of$800; <br /> Certifies that the Information supplied is We and correct to the best of Wainer knowledge. The applicant recognizes that they <br /> are solely responsible for submitting a complete application being aware that upon failure to do so,the steff has no alternative <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 information that you are asked to provide on this application is classified by State law as either <br /> private or confidential. Private data Is Information which generally cannot be given to the public but can be given to the subject <br /> of the data. Confidential data Is Information which generally cannot be given to ether 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 agendas <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 survsy.at the time the <br /> Certificate of Occupancy Is requested,a temporary Certificate of Occupancy may be Issued upon recelpt of a$10,000 <br /> escrow to ensure completion of the as-built survey and all efts Improvements. <br /> Applicant's Signature: Date: 0 <br /> Owner's Signature: f ��� Date: 2 <br />