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CITY OF ORONO IN 6122494616 08/30!99 15:41 15 :04/04 N0:414 <br /> r <br /> Please check one. New�>< Addition <br /> JOB SM <br /> Ovmer's NameR r sly Telephone Number <br /> Maung Address_t oyo TQ k ka 6--fa R..l. Deo t o y'4^1 <br /> Sprinkler Contractor's Dame Die r s 2 � �rte, Telephone Number <br /> Contact Person ) 0- 4- Q -t r S ------__ <br /> MadinS Address-- j/ �;k, o Q `� N.c,� - o ooti R i+71✓ <br /> Lake. A - Well City <br /> BACIM OW DEVICE <br /> AVS PVB <br /> Year of <br /> rinklers Maks Manufacture <br /> S S�wtttirit <br /> p - Toro - 7a o a9 9_ <br /> TOTAL OP-T-0 <br /> HYDRAITL.IC CALL-(IV r 3MNS Design Data- <br /> Area ofApplicadon, _ f 3L9�a +, Sq. Ft. <br /> Coverage per Sprinkler: 3 0 0 _ Sq. Ft, <br /> No. of Sprinklers: <br /> Total Water Required. ^. a VGPM <br /> P__RiMIIT FE�; CA,,,�I f s rrni►r <br /> 1, Permit Fee $—. <br /> 2. State SurehUg& S .34 <br /> 3. MaLiLItE1a $ 1.5D <br /> 4. TOTAL PEIiLMIT FVE(Add lines 1-3 above) S <br /> The undersigned hereby applies to the City for issuance of a Sprinkler Systcm 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 .— �--- Dee <br /> iiliiiiiMw4iYMiiiiitWiiiiiiftiiiiiiiiiiwiNifiYiiiiilii,iiisiiw+hiiiaiiiiii+ iiiiM«�■� <br /> Approved Approved with Corrections l� Denied _ W <br /> Reviewed by, Date < —/ <br />