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STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1.Structure Dimensions(continued) <br /> a. Length(ft.)= Number of bedrooms= N/A 2. Occupancy: ! -.:E M <br /> b.Width (ft,)= Number of garage stalls: <br /> 3. Occupant Load: ' 112 <br /> Areas in square feet Attached = ''''A <br /> c. Basement= 55,591 Detached= NA 4. Type of Construction: <br /> d. 1't Story = 26,179 <br /> /+ <br /> e.2nd Story= %,466 5. Code Edition: Z2/- <br /> f. '%Story = <br /> g.Total Area= L24 <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 /> ❑ l Building Permit Escrow Agreement and Fees <br /> ® 0 Plan Review Fee <br /> ® ❑ Completed Application Form <br /> ® ❑ Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'A x 11 set <br /> ❑ ® Minnesota State Energy Code Calculations and Mechanical Code Requirements <br /> ❑ ® Survey—2 full size,to scale(meeting ALL survey requirements) <br /> ❑ l Hardcover Calculations <br /> ❑ ® Septic System Certification <br /> l <br /> 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 /> ® 0 Stormwater Pollution Prevention Plan (SWPPP) <br /> ❑ l Access Permit <br /> ❑ ® Data Privacy Advisory Form <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$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 is 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 /> Applicant's Signature: _ Date: D5/2E/2317 <br /> Owner's Signature: Date: <br /> Last Updated: January 2016 <br />