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Nay-iT-2002 OT:28am From-CITY OF ORONO +9522494616 T-258 P.008/p03 F-812 <br /> ' fl <br /> . f � <br /> �,.�. <br /> . ��) <br /> Please check one: New x Additian L <br /> �os srrE ll5 ,frni�H /�v� D�'on��, mn/ _ <br /> , �vcmer'sName �i�� l���r�e�BE��=, � T����rr,�g�- ��5- �v�3 <br /> �$�aa�� i 1� ..fir��� �►�E o2v�'e� ir�n0 55 3� i <br /> I�- ' i� <br /> . Sprinkler Coniractor's Name I�ER[E�'So� - �su�Cu.. ,� Te,lephonel�umher7Cr3-�/7G-�31 a I <br /> Contact Person >AVE I��.�DNA m <br /> Mailing Address ,�,115 �n1�uSt��Z.ia�. ��- 1''11�1P1� 1�l.ra�N J m�.�' . .._ 553�`i <br /> � V�ATER S'CTPPLY <br /> Lake WeII�_ City <br /> �ACKFiAW ri�'V��`�: <br /> . <br /> AVB PV.R__ �-. <br /> ' � . Yea�r of <br /> 1Viake .M�del M�tufacteire uant' <br /> Spriaklers . � - Zb }��- � <br /> � <br /> � �,., <br /> G� r �b '?./ <br /> TCYTAY, <br /> �YI�RAITLIC CALCIIr,ATY�NS De�ign Dat�.: ��<< P��P � <br /> Axea af Application: � Sq. Ft. <br /> �av�rag8 per Sprinkler: (6�0� �a(?5 ' S �5 `'`'` Sq. �'t. <br /> No. af Spru�ctexs: ,"�0„�0�s r <br /> Total W ater Requirecl: � ��,� _ CPM <br /> PERNIIT FEE CA.�.��,,ATYON � . <br /> 1. Permit Fee $_ 35.00 � <br /> 2. ��e_Surcharge $ 50 <br /> 3. IV�ai1-Tn�'ee . � $ •�9 Clcl�vc.-r�� <br /> 4. 'Y'OTAT..PERMTI'FEE (Add lines 1-� ab�ve) � $ 3�. 50 � <br /> The undersigned hereby applies ta the City for issuance�f a Sprin4cler System Permit, agr�es ta do <br /> aII work in strict accordance with the ordinances of the City�nd State regulations, and cettifies that <br /> all st�teEnents made on this application are com,plete,true and c�rrect. t <br /> � � � <br /> (,.1,�. <br /> �PP�cant � �`" F3atc J �'7 D� � <br /> �**********�*�****�************s*************************�a*******************�** <br /> Approved � A.ppraved with C;orrections D�ied <br /> 1Zeviewed hy: �� <br /> _ �� S-ZI-��. <br /> X �n�1 �a� i n5�i f c t' ��,� �..1,t� (a�,.�I c}-t c� , . <br />