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• Apr-�7-2�03 10:05am From-CITY OF ORONO +952249d616 T-222 P.001/001 F-202 <br /> ease check one� New " Addition <br /> P1 _ <br /> JOB STTE <br /> Owner's Name�C� ��'h +. e '� Telephone Nuaiber qS Z `�y -�LP�� <br /> Ma�ing Aadress .UB�{ . ,�c�,���z�c .�}v� � z���t; Lci .��� /�i�-% -�S3 s_�i <br /> Sprinlcler Couuactor's Name TelephoneNumber <br /> Gontact Pecson <br /> 1VJa�ing Address <br /> WA'I"�R Si�'pLY <br /> Lak:e Well X City <br /> BACKFLOW DE'�E <br /> AVB PVB �C <br /> � ' Year of <br /> ake odet Ma�r ufacture ti <br /> Sprinklers _r���� f��r�� S�s�'�' ��f <br /> � � TOTAL <br /> '�� . . <br /> AXr1RAYTLIC CAL . n�AT'IONS Design 17�ta: � , <br /> Area�f Aprlication: � � � ��+*��- Sq. Ft. <br /> Cov�rage per Sprinkler: �� Sq.Ft. <br /> No. of Spruiklers: <br /> Tot2�l Water Required; !, /.� C''p� <br /> �FRNIIT�'EE CALCULA'ITQN $ 35.00 <br /> 1. Permit Fee $ 0 <br /> 2, State Surc � $ 1.�0 <br /> 3, Mail- n Fe . $ 3.� � <br /> 4. TOTAL PIERMIT�'EE (Add lines 1-3 above) <br /> The undersigned hi;reby applies to the City for issuance of a Sprinkler System Permit, agrees to do <br /> all work in strict acc:ordance with the ordinances of the City and State regutations, and certifies that <br /> all statements made on this application are complete, true and correct. <br /> A licant -�°r�� Date �-�/ � C� S <br /> PP �---.,� <br /> *****************�*******� ***�r************:r**�***��**********�*�**��*********** <br /> Approved���. Approved with Corrections D�� <br /> Reviewed by: �� ����� ]�ate �-(S '�3 <br /> � �1��� �'��''� �t�S�lC{=.G� w�1fc� �Qh'�p���QC� e <br />