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STRUCTURE INFORMATION: <br /> a_.._ <br /> 1. Structure Dimensions 1.Structure Dimensions(continued) 2. Type of Construction •�.•"`� ;/,�/� <br /> ..��`S C� <br /> a. Length(ft.)= Number of bedrooms= �`�/ood/Frame � <br /> b.Width(ft.)= Number of garage stalls: Mas ry �C C v�c+G1 u�� ��C--� <br /> / <br /> Areas in sauare feet Attached= � e � C� �e ` �Q��� � <br /> ❑ P e Bldg. � <br /> c. Basement= Detached = � ,�, <br /> ��� <br /> d. 1 St Story = �On- ite Prefab <br /> e• 2"d St°ry- [(] Off- 'te Prefab <br /> f. '/�Story = �] Othe (please specify): <br /> g.Total Area= <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed A licable <br /> R R� � �s� -� Buildin Permit Escrow A reement and Fees <br /> ❑ ❑ Plan Review Fee <br /> ❑ Com leted A lication Form <br /> ❑ Pro osed Buildin Plans-2 full size sets,to scale and 1 reduced 11 x 17 or 8 Yz x 11 set <br /> ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements <br /> ❑ Surve -2 full size,to scale meetin ALL surve requirements <br /> ❑ Hardcover Calculations <br /> ❑ O Se tic S stem Certification <br /> � ❑ Minnehaha Creek Watershed District(MCWD)Permit or <br /> ��,,�,o�S �.Dz �ji� Documentation from MCWD statin no ermit is re uired <br /> ❑ Landsca e Walls and/or Retainin Wall Plans <br /> ❑ Stormwater Pollution Prevention Plan SWPPP <br /> ❑ Access Permit <br /> ❑ ❑ Data Privac Adviso 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 govemmental 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 sunrey and all site improvements. <br /> ApplicanYs Signature: ��= �' Date: � � <br /> Owner's Signature: Date: <br /> Packet Last Updated: August 2015 <br /> Page 22 <br />