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w <br /> . . <br /> � � , �O�O City of Orono FOR CITY USE ONLY <br /> P.O.Box 66 <br /> 2750 Kelley Parkway Date Received: Permit# <br /> Crystal Bay,MN 55323 <br /> Phone:(952)249-4600 Fax: (952)249-4616 Approved B . unt S: <br /> y���kFs o���� CITY OF ORONO—LAWN SPRINKLER PERMIT <br /> H <br /> PERMIT CODES(IN-HOUSE) <br /> Sprinkler/Residential/Lawn Sprinkler/Blank <br /> Sprinkler/ResidentialBacl�low Device OnlyBlank <br /> Job Site Address: �(��b � � � (� �M <br /> Owner: �Q Telephone Number: �,�Z � 7,��"�7-� <br /> Mailing Address: Z��ij� I` � P ���e <br /> c�ri: �1✓' � z�p: �'S—s33 > <br /> Sprinkler Contractor: bU �or¢/llare Telephone Number: 9rz-- �j 6—�/�� <br /> Contact Person: �y'/�°j/� License#: P�'1 ���9 Z�3 <br /> Mailing Address: P. d� ��G �`�'f� v� � �Q�i� �f� �� ��j",�. 3�� <br /> WATER SUPPLY <br /> Lake ❑ Well ❑ City� <br /> BACKFLOW DEVICE <br /> AVB� PVB ❑ <br /> Make o/���S Model �� �bZb Year of Manufacture ZDI y 6 j Quantity� <br /> � <br /> Sprinklers: �Ld . <br /> HYDRAULIC CALCULATIONS Design Data: <br /> Area of Application: ,Q,�iy, �dv Sq. Ft. <br /> Coverage per Sprinkler: ���Q�-/S(� Sq. Ft. <br /> No. of Sprinklers: �d � 3(B <br /> Total Water Required: _____ s br �°sS GPM <br /> p�sr �ah e <br /> PERMIT FEE CALCULATION <br /> 1. Pernut Fee: $ 50.00 <br /> 2. State Surcharge $ 5.00 <br /> 3. Mail-In Fee $--.T <br /> 4. TOTAL PERMIT FEE(Add lines 1-3 above) $ <br /> The undersigned hereby applies to the City of issuance of a Sprinkler System Permit, agrees to <br /> do all work in strict accordance with the ordinances of the City and State regulations, and <br /> certifies that all statements made on this application are complete, true and correct. <br /> Applicant O Date l� /� <br /> ........................... ... .................... ... ... ............................................................................................................................................ <br /> Approve pproved with Corrections Denied <br /> Reviewed By: Date <br />