Laserfiche WebLink
`f �,/ <br /> � <br /> Please check one: //New Addition � ,3�� <br /> JOB SIT$ <br /> Owner' s Name v�/ � �� s�i/"T�•'�!' � Telephone Number <br /> Mailing Address ��6� ,$' ���'t� �v����� — <br /> � , �; �/�G C S Tele hone Number ��S - �`n�=� <br /> Sprinkler Contractor s Name��✓� ;�f' P <br /> Contact Person �i�Q <br /> Mailing Address ��- .��-r � � � ��•-'/C�`"-� �''�"'� � ��yJ <br /> **�#*****#*****t* ********t:************�** **�**************#�********�*** <br /> CLASSIFICATION OF OCCIIPANCIES <br /> Commercial Residential <br /> �*t***************�*#****t****:*�**�**#***t**t***f*****�**�t*********t**�** <br /> WATER SIIPPLY <br /> Lake Well City <br /> *********************�****:*�**#*****#�* *****#****************�**�******** <br /> Year of Orifice <br /> Make Mode 1 Manufacture Size uantit <br /> rink ers -�o,?� � i�o /iri/ ' <br /> �v . � 3�c?- �'2 /: j/ <br /> at'��' '%4 / 7/ <br /> TOTAL <br /> *�*************:*******#****************#****�**:*************�***:#******* <br /> HYDRAIILIC CALCIILATIONS Design Data: /' <br /> Area of Application: �/��` Sq. Ft. <br /> Coverage per Sprinkler: �oc� Sq. Ft. <br /> No. of Sprinklers: <br /> Total Water Required: ;���E: GPM. <br /> ****�****#*********�****************�*****�******�*�*****�******�********** <br /> PSRMIT FSE CALCIILATION <br /> 1. Permit Fee $ 30. 00 <br /> 2. State Surcharge. Based on valuation. $ .50 <br /> 3. Mail-In Fee $ 1.50 <br /> 4. TOTAL PERMIT FEB add lines 1-3 above S <br /> The undersigned hereby applies to the City of issuance of a Sprinkler <br /> System Permit, agrees to do all work in strict accordance with the <br /> ordinances of the City and State regulations, and certifies that all <br /> statements made on this application are complete, true and correct. <br /> `�� - �:-- `� <br /> Applicant � � Date � �� <br /> *************************************************************************** <br /> Approved_� Approved with Corrections Denied <br /> Rsviewed by: <br /> -- 2�.�.�.--� ��7�l � <br /> Date <br /> � <br /> �, <br />