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JUN-04-01 MON 16 :51 SPRINKLER SYSTEMS INC 9221172 P. 02 <br /> YV11 V��LVVI uc.4upm rrvin-�ii� ur �Kunu +A522494816 T-188 P•009/009 F-280 <br /> � � <br /> ♦ <br /> � ,� ��� <br /> . O <br /> Plea.se check one: New A,dditiQ�p� <br /> � � i <br /> ro� �ri� 2 y� �� ���h�e�� , �� �a�� / � <br /> Owner's Name � i�� TelephonaNumber �S�— ��'r'J-��f�� <br /> Ma�.ing Addr�ss '2 S � , , z ' � . <br /> Sprinlcler Contracto�s Ndm�S ' ��1 e r �.r����Te�eghone Number_9>Z--9a�--/�v�. <br /> ContaCt person. �n c../� �� �,;�„ <br /> Ma.�ing Address��,p� � l!) 1-7� `�..� �'� y;r���_ SS�f2.ro� . <br /> ATER S�CTpP�� ? <br /> Lake_^___, �Vell City � �,,,.� <br /> ,�� 0.�� 6��� p� � �� ��� . <br /> 7 "�ha.�� t ��— �0. �`� <br /> �A��I.O'�'V DE�TC._E_ � • &�c.k� T� �- � ��'o � � <br /> � AVB _____ pVB �____ � - <br /> � Yeat of <br /> ake ode M`a u►_ f�a.ctura ua i <br /> Sprinlclers --- <br /> ..� --- <br /> � � . ., ' � 7�'QT�i'�. ' ^_ <br /> HYD�2AU�I��AL.C�CT_X�ATIOI�L�, Des'�gn L1ata: ' <br /> Area.of Applicatiori; C��� �/ � R Sq.�t, <br /> Coverage per Sgrit�kler: T Sq. �t. <br /> N'o. of Spri�clers: <br /> Total Water�equired: GP� <br /> p�R,�.ITY' E �ALCULATTO�T . <br /> 1, Ferc�it Fee $ .0 <br /> 2. �,ta�� Surch�Qe � _50,_ � <br /> 3, ail- n e - � 1 SO <br /> h, 70TA.�PER�YIIT�� (Add lines 1-3 above) . �� 7 � ��t> <br /> � �'he undersi�ned hereby applies to the City fQr issuance o£a Sprinkler System Permit, agrees t4 do <br /> �]1 work in st�iCt accocdance with the ordinances af the City and St�le reguiations, and certifies that <br /> all statements rr�ade on this applic$teon are complete,true and correct, � � <br /> Applican�_ Date. (p ��� _ _ <br /> �*****��**��***��# �• *�********:�����:�*�r****���&***��***w*�********�*****��k*���� <br /> (� �,..'.�� S� �,S.�.;".� •.-='�� �'.�..,,\ c r�,.,.�.`� <br /> Approved �� i� Approved with Cvtreccions ��'���� `�� P� l�e�ied________.�.� <br /> �t�viewed by: �� �2^^�,�-__ �- 5- G �� <br /> Daie <br />