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STRUCTURE INFORMATION: <br /> 11.Structure DimensionsK i 1.Structure Dimensions(continued) 2.Type of Construction <br /> +• saiLl <br /> ii <br /> Width dth(ft.)= S <br /> { 2 —0 Number of garage stalk: 0 Masonry <br /> Areas in square feet Attached= 3 0 Metal <br /> I its_ <br /> c. � Detected= <br /> 1lalCF <br /> d.114 Story = 11.-t I. <br /> 0 <br /> e.2'd Story= ‘4,11--- Off On-site Prefab <br /> [a f Prefab <br /> %Story = 0Other((ptesass <br /> g.Titbit Area= <br /> ." :"Ki l;:Sfr : <br /> AU Elbe uatfranalionfinusi1iest bi ii int older`frwyour zoikaaffionI0 <br /> Ndt <br /> Enclosed Applicable _ • <br /> o 0 Permit Application <br /> I E int PeeposaalDuliNngrials <br /> tEl El tiltilllitzitettedeezhollefienserslihieclhankelOodeRequiremeres faun ' <br /> T T3 Survey/meeting ell e drama tug) i <br /> ❑ 0 Stormwater Pollution Prevention Plan <br /> O 0 Hardcover Calculation(s) <br /> Et I in I } <br /> ID 1 ® AncessPentill <br /> la i Rlf IlilkitlandadfkrtirnproverneritPl <br /> o ❑ Engineered Plans for Retaining Walls 4 feet or above <br /> ❑ 0 Mlnnehaha Creek Watershed District Permit(s) <br /> tEl I I Plan ItedewiFee <br /> ® itAnt ®rrri& 1 <br /> APPLICANTIOIMNER ACKNOWLEDGEMENT: <br /> ' w illgyanatepoultdeadlliefornattienteaceleaderi by lh ildf i melt; i <br /> • Agrees to pay the City of Orono for engineering consultant review costs in excess of$5001 <br /> fi • Certifies that the information sypplied is true and correct fo the best of bislber.knoudedge. The applicant=cognizes,thatthey, <br /> cam set r tor ; *ht won hazeo do so, states e erne 1 <br /> hello i r2ttifterltilittis , 1 <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 Slate.law as eliber, <br /> hate=serffithetel. rent&dela 9s hitemetien Which greassilly caned he gem Itolhe bel wan h glean toile subject` <br /> OYMedea. Caefatetifiel Fes klannittienltit eaurtdt he givento slaw ltre racarortlhe alike Olin. Der <br /> purpose errfi lMteneted erste ell this'hifurrnailion Is'to wreath(emgy e!pflobe var melds end'records of ether Wvernmeritdl t,avr'atm <br /> required by law. If you refuse to supply the information,the application may not be Issued. <br /> 1 y. Apses thid to the mese She overetber car enter enseditiens weed the sateupletien Oen rewhillitt survey at the iis e the <br /> Oliebraiteof its and Deseparow sew be" moan sesadOefra IMAM I <br /> esusewttoensuresonnptelizer etas atelbeftbsurseyentif+rillsaie >tjis. 1 <br /> rcaraift igrritare: /1 Das: y- I <br /> Owner's Signature: — G �l& " W�0 Date: 6 �)2' ' <br />