Laserfiche WebLink
_� <br /> , .. � ���� <br /> lease 'check one: �New Addition <br /> R�OB SITE ��� {-���?J i �/��[�^ ��•� <br /> ���,vrier' s Name �� ; ( � �-� �►�-1�� Telephone Number <br /> i�5ailing Address �'� �� <br /> "L:rinkler Contractor' s Name �-� -�-�f�;������) Tele�hone Nuinber 5 5 �" ����'� <br /> Contact Person ��I� ��l� r-� <br /> ��Ia i 1 i ng Addr e s s )D �� �"% �? � ���'"�'Q(J�l-� �'�'1�J � � �i`�-�--- <br /> ��t�k***�t�t�t�t*�t�tit�t��t*zt�c�t�t�tf�t�t�tf�tytitit�t�tic�t�tit*�t***t�t�t�c�tic�t**�t�c*�tit�t**�t*yt**iryt�t�k*'**1t** <br /> �I�ASSIFICATION OF OCCIIPANCIES <br /> Com*nercial Residential � <br /> :�f�**f�**t****�***�f**��***�********x**�**t*t**��***�******�*�*****�*�**** <br /> WATER SIIPPLY <br /> Lake Well _ City <br /> �:�**�*********�*****�***** *�**��**��*********�****�*��*t**t�***#*���**�**�r <br /> Year of Orifice <br /> Make Model Manufacture Size uantit <br /> '�-rinklers U1��,1 �� �� �G�'� r�- <br /> � k'�i�.-�(� .�� i�o� �Z I o�G'rr, „ .,(..> <br /> - - TOTAL <br /> ��*��*��:�*****�r********t***��*�***�**f********�#�**�**���t�e******�*f***�**�* <br /> 1�'�RAIILI C CALCULATI ONS �e s i gn D t a- �, �4� <br /> Area of Application: � ����� Sq• Ft. ��� <br /> Coverage per Sprinkler•.� Sq. Ft. ' ' � <br /> No. of Sprinklers: �✓ ��ta6 � <br /> Total Water Required: �� GPM• 4 �' <br /> ���*�*�**f�*�**********�**********�*******�*�****�****��*-�***�r*���r*�*��r* <br /> PERMIT FEE CALCIILATZON 3 � �, <br /> $ �_�. " �`", <br /> ' . Permit Fee .50 ' <br /> ? . State Surcharge. Based on valuation. $ <br /> 3 . Mail-In Fee $ 1 . 50 <br /> � . TOTA3� PERMIT FE$ add lines 1-3 above $ <br /> ��"�e undersi.gned hereby applies to the City of issuance of a Sprinkler <br /> S�stem Permit, agrees to do all work in strict acco�dance with the <br /> ordinances of the City and State regulations, and certifies tha�. all <br /> stu.tements made on this application are complete, true and correcte <br /> ' ant � "" �_`-� Date � � � � <br /> Applic <br /> ���t�****2x***********�r**�t**** ***** *********�**************�t**�t����t ����� <br /> rpproved ��Approved with Corrections Denied <br /> ?eviewed by: <br /> a �"�-�� .��� �� <br /> - Date <br />