Laserfiche WebLink
t , <br /> STRUCTURE INFORMATION: <br /> 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction j, <br /> a. Length(ft.)= (2-Ott Number of bedrooms=.0 <br /> I(f Ei Wood/Fra e 2 KC <br /> b.Width(ft.)= ,57-0 Number of garage stalls: ft Masonry C UraPi C ` / <br /> III <br /> Areas in square feet Attached= 3 `�':, etal p <br /> I Pole BI ,- 1 <br /> c. Basement= to7C Detached= <br /> N .ICF ©/� fA� <br /> � YV� /lll <br /> d. 1S'Story = Iii-/F6 1II P -so- •refab <br /> e.2nd Story= Hyiil' ( ' j 1 <br /> ` 11 Off.i • -refab <br /> f. '/Y Story = 11 <br /> • II 0 ell• -ase specify): <br /> g.Total Area= 5765 <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 /> 19. 0 Building Permit Escrow Agreement and Fees <br /> 6 0 Plan Review Fee <br /> El 0 Completed Application Form <br /> 0 Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8 1/2 x 11 set <br /> 0 Minnesota State Energy Code Calculations and Mechanical Code Requirements <br /> al 0 Survey—2 full size,to scale(meeting ALL survey requirements) <br /> ❑ ❑ Hardcover Calculations <br /> g 0 Septic System Certification <br /> ❑ ❑ Minnehaha Creek Watershed District(MCWD)Permit or <br /> Documentation from MCWD stating no permit is required <br /> ❑ a Landscape Walls and/or Retaining Wall Plans <br /> ❑ ❑ Stormwater Pollution Prevention Plan(SWPPP) <br /> ❑ 0 Access Permit <br /> EL 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 /> Applicant's Signature: Date: ]-Z I-/( <br /> Owner's Signature: Date: <br /> Packet Last Updated: August 2015 <br /> Page 22 <br />