Laserfiche WebLink
, � �. <br /> Please check one: New ✓ Addition Limited Energy Technology <br /> Systems License# ts01656 <br /> PL—'C #�����33`vY <br /> JOB SITE 2599 Casco Point Road,Orono, MN 55391 <br /> Owner'sName ��m Daily TelephoneNumber (612)865-0805 <br /> MailingAddress 2599 Casco Point Road, Orono, MN 55391 <br /> SprinklerContractor'sName ���gation Doctorinc. TelephoneNumber �763) 571-7555 <br /> ContactPerson Randy Holt <br /> MailingAddress 601 Rice Creek Terrace NE Fridley, MN 55432 <br /> WATER SUPPLY <br /> Lake ✓ Well City <br /> BACKFLOW DEVICE <br /> AVB PVB <br /> Year of <br /> Make Model Manufacture uantit <br /> Sprinklers Rain Bird 5004 Rotors 2007 75-85 heads <br /> TOTAL <br /> HYDRAULIC CALCULATIONS Design Data: � ��C L� 5��� `'''-'�- �`� N a "� N ct� <br /> Area of Application: �c� cdo {��S Sq. Ft. <br /> Coverage per Sprinkler: Sq. Ft. <br /> No. of Sprinklers: <br /> Total Water Required: GPM <br /> PERMIT FEE CALCULATION <br /> 1. Permit Fee $ 35.00 <br /> 2. State Surchar�e $ .50 <br /> 3. Mail-In Fee $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines l-3 above) $ <br /> The undersigned hereby applies to the City for issuance of a Sprinkler System 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 /> � <br /> ,.-- <br /> Applica, Date ; �� <br /> ,�k***#.�Ik************************************************************ ************** <br /> �-. ✓ <br /> Approved /� Approved with Conections Denied <br /> Reviewed Bv: � Date �O �� �7 <br /> Reset Form <br />