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04/17/2007 09:03 FAX 6517489143 S D F C�002 <br /> � �� (�() , <br /> . ,� 7C� . z,��� -'� �� <br /> , ` <br /> S, ,�T� � '. /,�.� .' �.�' t r�M <br /> ��:`�e Y4 - �i u�%4 t�} � .! .�1�k: <br /> �, . q (f .(`.t. .��. <br /> `.:. � <br /> ...!<:�'. .lo��,�' u ''-M1�:Y3 t n,Y*.'. <br /> ❑ New ✓0 Addition ❑ Remode] ❑ Replace <br /> � <br /> ,, �� , <br /> �� F�l;� ,'a�7d� �� I *I,r'k <br /> 2060 6th Avenue North <br /> Site Address: ._ <br /> Trinity Lutheran Church 2060 6th Avenue North <br /> Owner: Mailing Address: ,_ <br /> Orono 55356 <br /> Clt}': Zlp: — <br /> Home Phone: Alternate Phone: _ _ <br /> , ��.�• .s � <br /> ,, u �a,�:� <br /> � <br /> Contractor/A ��re-Guard Sprinkler Contact Person: c�►ris x�.N�e�x <br /> PP• _— <br /> 575 Minnehaha Avenue West C-018 <br /> Address: State License#: _ <br /> St.Paui 55103 06-30-0� <br /> City: Zip: Expiration Date: _ <br /> (651)748-9499 <br /> Phone: Alternate Phone: _ _ <br /> �,,. ,� � p� .� � � <br /> ,_. ��,.' � ,��£' � .i.. 'r '_�1�l4.. ;:SW � � �� <br /> Q Commercial–Fire Sprinkler ❑ Residentia!–l�ire S r��'nkler <br /> Fire Sysiems Permit Fire Systems Permit <br /> 36,200.00 452.50 <br /> *Base Price=Contract Price:$ x.0125 =$ (Minimum$35.00) <br /> 36,200.00 18.1 <br /> *Surcharge=Contract Price:$ x.0005 =S (Minimum $ .50) <br /> *Mail-In Fee(Only On Mail In Applications) _$ 1.50 <br /> *Total Cost of Permit: _$ 472.10 <br /> The undersigned herby applies to the City for issuance of a Sprinkler Systems Permit. Applicant agree� <br /> that all systems shall be designed,installed and mai,ntained to N.F.P.A.-13,N.F.P.A:25, Minnesota Sta:e <br /> Building Code,Minnesota State Fire Code and Standards,and certifies that al] statement��made on this <br /> applicarion are complete, rue and conect. <br /> �����2r.cn r <br /> �f'-�-o�� <br /> Applicant Date <br /> ��t ����� �,� u:�� r i.�� �� ���� � y` ��� v � W 1 I/f/�'/IL�e� <br /> ,.� �:. <a� � , ' '� <I /�(�/�-��e �G . <br /> 4.' . . <br />