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� � . <br /> ;�.�;,: . .. <br /> r � <br /> � k � <br /> t <br /> .�� <br /> f t+ 1 <br /> :.F . _ ! <br /> !�P,:�'�����, �. . . <br /> �::5:' r <br /> �1��:�P <br /> "��� PLcase check ene: New __. _ Addition� Limited Energy Tc�hnology <br /> i .Systems Licensc#� __ <br /> JOBSITE .�S'" �y r��-__������.. �� c;�fZ.i�ticU � �S`�� <br /> .�-�'"`' — � <br /> Owner's Name S�T�d� �Co�t�c�[�. _ Telephone Ni.Qnber��-`f'7!a � <br /> ;. <br /> MailingAddress ,.�,��?�__�'e-�"-� _(�_ (S(t.��l D S'�`'�-S'Z.o _ <br /> �"�`' S rinA.Ier Contractor's Nam� '1h.� � <br /> p � '� S%s5 'r��:c-��;T�lcphone Ntunber___1-S Z " `���-����p <br /> ;� ContactPerson pL�� ._�,�a�� �.�, ^ . �.� i z.:- ���z�(�>�'�c°� <br /> ;��' - �' ,., _ ',' <br /> � M3111ri��,d(�Te55,� O Z- �',�c O.�h� � ��/� i'� '.`���.�L=. ��� �� � i � ., ��, <br /> �� J�.�I�I �-t�ti,;���� <br /> �vAr s���y ' <br /> ''�� Lake_ . Weil_� City_�_ <br /> �CIi.F,.&OW.��YXCE �� �� ��� s-- <br /> AVB _ Y VB � � <br /> Year of <br /> Make odel �vla�nufdcture u� t� <br /> 'g,�;;' Sprinkless _..�_���F� �- �C•���- � �� O s ��S - zQ <br /> �� � ._._ .. .._____�_ . --- - _.._ _ _ ._ ._ <br /> �;� ...�. ---.ti_ ._ �.. __ _ <br /> ,. _____ -. _._."_ TOTAI. <br /> � ��'Y.DRAULiC CAT..CUL�.��4NS Desi�Data: <br /> --- Area of Applicatic�n: , ��'�d C;�Sq. Ft. <br /> Coverage per Sprinkler: __ ��•�;-�_ ;� _ Sq. Ft. <br /> 1�0. A�Sprinkleis: ��- � •� _ . . __ . <br /> Total Water Required: __� ; ►�!1� GPM <br /> �_ ._ <br /> '.�.; �'ERMIT k'E_��,CULATIOIV � <br /> ,..: 1. Permit Fee c� �S.QQ <br /> Z. Statc: Sur�l,ar�e � .Sp � <br /> 3. N��1-In Fee $ I.50 <br /> 4. TOTAL P�Rh1IT FEE (Add iines 1-3 above) $ • � 5 �� <br /> 7�'te undersigned heteby applies to the Gity for issuancc o�'� S�rinlcler System Permit, agtees to do <br /> ail work in�trict a�cordante with ttic ordinances of the City and State regulati�ns, and certifies that <br /> aII statcments made on this application nre eornplete, true and correct. <br /> Apglic�nt - - - � � T?ate ��.���Q/ <br /> - -- �-- -.---�--�—�------� <br /> #rir,r,e�i#I�+kb##�}'F## �k�F?K��M�F�k�A���M+P�F�M4�k�k�k#�y�t*#*�*�K#�MfT+�M�i�!k*�k�k�k�k**�k*iM�k�M�M*�h�k*�*4�*�MM <br /> Approved y_,___^ Approved wiih Corr�ctions D��v����` <br /> Revi�wed� : ��``�C ��_ t �`� � v � , . <br /> �' ..�—, � Da_e � <br /> .�� '�C C��� ,(-c, ;���c�}-Q_ .,_�t� �:���5��� -- <br /> T0 'd �S6S0S�5�i9 �98 WC �T : 90 i0-£0-d3S <br />