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REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed Applicable <br /> ®' 0 Building Permit Escrow Agreement and Fees <br /> ❑ Plan Review Fee <br /> 0 Completed Application Form <br /> 0 Proposed Pool or Hot Tub Plans–2 sets, full-size, to scale <br /> Ga" 0 Survey–2 full size, to scale (meeting ALL survey requirements) <br /> 0 Hardcover Information <br /> Er 0 Septic System Certification <br /> 0 Minnehaha Creek Watershed District(MCWD) Permit or <br /> documentation from MCWD stating no permit is required <br /> ❑ A 0 Landscape Walls and/or Retaining Wall Plans <br /> ❑ 0 Stormwater Pollution Prevention Plan <br /> ®' 0 Data Privacy Advisory Form <br /> 0 <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Planning & Building Departments; <br /> • Understands, if applicable, an as-built survey and as-built hardcover cover calculations, are required to be submitted after the <br /> project is complete(including final grading and landscaping)prior to refunding the escrow; <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 /> • 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. If <br /> you refuse to supply the information,the permit may not be issued. <br /> 11111Mi. <br /> Applicant's Signature: .�� Date: 2/27 ; 7 <br /> Owner's Signature �_l a, Date: l/ 2 7 <br /> // <br /> 06 c/vp 014 Cy— J__„46-- <br /> Tito <br /> 6-- <br /> Tito ti or -C (le fro ---ar`14 <br /> cd, ict.4070 - <br /> Packet Last Updated: April 2016 <br /> Page 23 <br />