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�0(�v��"d <br /> ' _ � -/-D� <br /> Please check one: New ✓ Addition Limited Energy Technology <br /> Systems License# <br /> JOB SITE �386 rest point road <br /> Owner's Name Jay nygard Telephone Number (952)472-2842 <br /> MailingAddress 1386 rest point road <br /> Sprinkler Contractor's Name none Telephone Number <br /> Contact Person <br /> Mailing Address <br /> WATER SUPPLY <br /> Lake ✓ Well City <br /> BACKFLOW DEVICE <br /> AVB PVB <br /> Year of <br /> Make Model Manufacture uanti <br /> Sprinklers orbit lawn sprinkler new 20 <br /> misters orbit garden mister new 8 <br /> drippers orbit plant drippers new 20 <br /> 'I'O'I'AL <br /> HYDRAULIC CALCULATIONS Design Data: <br /> Area of Application: 6000 Sq. Ft. <br /> Coverage per Sprinkler: various Sq. Ft. <br /> No. of Sprinklers: above <br /> Total Water Required: 50 GPM <br /> PERMIT FEE CALCULATION <br /> 1. Permit Fee $ 35.00 <br /> 2. State Surcharge $ .50 <br /> 3. Mail-In Fee $ ,t}sg- <br /> 4. TOTALPERMIT FEE (Add lines 1-3 above) $ <br /> The undersigned hereby applies to the City for issuance of a Sprinkler System Permit,agrees to do <br /> all work in strict accordance with the ordinances of the City and State regulations,and certifies that <br /> all statements made on this application are complete, true and correct. <br /> Applicant � 08/01/06 <br /> ************ *** ************************************************************ <br /> Approved Approved with Corrections Denied <br /> Reviewed By: � it,� ��� Date -� — �CO <br /> Reset Form <br />