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1. Structure Dimensions 1. Structure Dimensions(continued) 2. Type of Construction <br /> a. Length (ft.)= /04%, Number Number of bedrooms= g 5— <br /> /Frame <br /> b.Width (ft.)= 1 Number of garage stalls: 3 asonry <br /> Areas in square feet Attached= / ❑ Metal <br /> c. Basement= / 79-0 Detached= ❑ Pole Bldg. <br /> d. 1st Story = /6 85- <br /> El ICF <br /> ❑ On-site Prefab <br /> e. 2nd Story= / 21 <br /> ❑ Off-site Prefab <br /> f. 1/2 Story = <br /> �• 0 Other(please specify): <br /> g.Total Area= c2 <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Englobed Applicable <br /> ❑ Building Permit Escrow Agreement and Fees <br /> ❑ 0 Plan Review Fee <br /> 1 0 Completed Application Form <br /> .$( ❑ Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8 1/2 x 11 set <br /> ilZ 0 Minnesota State Energy Code Calculations and Mechanical Code Requirements <br /> O Survey—2 full size,to scale(meeting ALL survey requirements) <br /> ❑ X Hardcover Calculations <br /> 0 Septic System Certification <br /> O Minnehaha Creek Watershed District(MCWD) Permit or <br /> Documentation from MCWD stating no permit is required <br /> ❑ Landscape Walls and/or Retaining Wall Plans <br /> ❑ Stormwater Pollution Prevention Plan (SWPPP) <br /> ❑ Access Permit <br /> IRC 0 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 /> .. <br /> Applicant's Signature: (32111Date: lU <br /> Owner's Signature: - / Date: .89/2-/ /6 <br /> Packet Last Undated Auaust 2015 <br />