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May-11-2004 08:09am From-CITY OF ORONO +9522494616 T-190 P.002/002 F-264
<br /> Please check one: New '� Addition Limited Energy Technology
<br /> Systems License#
<br /> JOB SITE �-�:.^^-,� �LS ��l�,_ti
<br /> Owner's Name <<�'�� S��,�-�r�T Telephone Number �- �a -c��� -��'�
<br /> MailingAddress 9�% f=c.'n��(� �r�c�;� t,�J��yr�-�-�..,f n-��-� ,_, 5�53� •—
<br /> ��L r
<br /> Sprinkler Contractor's Name�o,-��l t-�• �:��r t-�����o�°�'`�elephone Number 7�3-a�= �����
<br /> ContactPerson ,'� ` ����%L`� ��
<br /> MailingAddress �I�S`7 Tr��,�_���-� C'_�.�;� L (����_ �J�Y� , `�Ltn,� Sa�l�
<br /> WATER SUPFLY
<br /> Lake Well City X
<br /> BACKFLOW DEVICE
<br /> AVB PVB�
<br /> Year of
<br /> Make Model Manufacture uanti
<br /> Sprinklers I �^� 5 Tp e- �cx� ,�-c'c�"y .._.... 3`'f _
<br /> 'Tc r' c.� 1'��h i —�',..... �`_c:%',/ �
<br /> T07'AL y 3
<br /> HYDRAULYC CALCU�,ATIOI�iS Design Data:
<br /> Area of Application: ���,✓� I v� ��_�,� ��rc�� ^ Sq. Ft.
<br /> Coverage per Sprinkler: 3�--Nc%' Sq.Ft,
<br /> No, of Sprinklers:
<br /> Toial Water Required: �.5 �pM jSP����(fr- ��C4�
<br /> N to 5 ��e•=��5 Zan� = iC —/2 -S CG�/Zo.,��
<br /> P� T F E CALCYTL,ATYO ` �t _.Z�.�.,e-,�
<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 1-3 above) $ 3�• ��'
<br /> The undersigned hereby applies to the City for issuance of a$prinkIer System Permit,agrees to do
<br /> all work in strict accordance with the ordinances ofche City and State regulations,and certifies that
<br /> all statements made on i application are com lete,true and correct.
<br /> �
<br /> C �-�- 1v
<br /> Applicant Date 5 ���-J 'Y
<br /> ******************************«*�***********«******�**,•*************�**�*****��**
<br /> Approved � App ved with Corcections Denied
<br /> Reviewed By: �� Date �� " � �- � I
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