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CiTY OF ORONO � 512z494616 Q8131/99 11 :45 � :Q3/03 N0:431
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<br /> Please check one; New ✓ Addition
<br /> Ja� 51'TE
<br /> Dwns�'s Name ���,�-�%.�C��� ---- Te�ephoneNumbor.�.�o��fa�6
<br /> Maili�g Addresa ��',�U ,�}yy.,,�-��� ��A�� ��iQ�,�S/� /1�'i,•!.
<br /> Sprinklcr Contractc�r s Name,,�/�r,� �j,��� �V:�Tdcphoz�cNumber{�/�2�-�'�'-����
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<br /> Cont�ct Pcraon�iH�- Sii✓A�,SOrV �- -��.��� /✓��.G L-f��i�
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<br /> Mailang A.ddre�a ;rc7�'o ��i�I�i���1/.�.,,_f��i�o}/�. .Y 5.�_,��/
<br /> �'�'�'FiB.�YIPpLY
<br /> Lake�� Well�_ City�_
<br /> ���C��T�
<br /> �AVB PVH�_
<br /> Year of
<br /> � �,� Manvfacture �f�������
<br /> Sprir�klers �Ainit3� :� i-�3>i�.7� G �l� /� � _
<br /> ,�i.� `�i�;��� �=-i,► ��.�o„��s ..,.. 21�. �,�
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<br /> ro�r�►i T��5,�
<br /> $�►S}�S; �,PL��r��.�rt1���� I�esign Data,
<br /> Arca of Application: � 704 Sc�. �'t,
<br /> Caverage per Sprinkler. 7�' f``�1'� — � � T�!�q. E't.
<br /> No. of Sprinklcrs: ".,h.��l`�o S,�-�,�,��5r�?,at„�5=-��
<br /> Tatal Watcr Required: „W„�„�-�o�� �-F����_ _,,,�,_CrFM
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<br /> �.Ai�li.Li�J A , ��f.�ld.f1�h�SE�
<br /> 1. Permit Fce � ,�,�,QQ
<br /> �, �"tate Surct�ar�c $�,_,,,�Q,_.,�,._,
<br /> 3, �il;�e �
<br /> a, TQTAL PERMI'�'F�E (Add linos 1-3 above) $� ). �
<br /> '1'he underaigned hereby appli�s ta the City for issut�nct af a Sprinkler Systcm Pcrmit, agree�tn do
<br /> pll wock in strict ac�ordance with tlic ordinances of the City nnd 5tate regulations, and ccnifies that
<br /> all statoments made on thi��p�licatian are complete, true and correct.
<br /> Applfcant � � l��ta 7
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<br /> Approved�� Approv�d with Correctians� Dcn'tcd
<br /> Reviewed 6y� � � q
<br /> _ _._. Date 9 ' �3 ` `�J
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