Laserfiche WebLink
(;,.;�p�;� City of Orono FOR CITY I,SE OVL1' <br /> ,/O � } P.Q Box 66 ��y �/ <br /> p: �+, , y� 2750 Kelley Parkway Date Reeeived:' `� ��� Permit# <�'�� � ���� <br /> '�i,� '����`��� ���� Crystal Bay,MN 55323 <br /> � ''��,������e��"� Phone:(952)249-4600 Fax: (952)249-4616 Approved By: Ainount$: �' <br /> ���� � ,.....�.:°r <br /> � � I CITY OF ORONO—LAWN SPRINKLER PERMIT <br /> PERMIT CODF.S QN-I IOUSF?) <br /> Sprinkled Residential!Lawn Sprinkler/Blank <br /> Sprinkler'ResidentisUHackllow I�evice Onh�iBlan6 <br /> Please Cheek One: N�w ❑ � Addition �� � � � <br /> Job Site Address: 3095 NORTH SHORE DRIVE <br /> Owner: SIME RES Telephone Number: (612)816-1455 <br /> Mailing Address: 3095NORTH SHORE DRIVE <br /> City: ORONR MN Zip: 55364 <br /> Sprinkler Contractor:GREENKEEPER INC. Telephone Number: (952)546-0436 <br /> Contact Person : BLAKE HAWKENSON License#: <br /> Mailing Address: 12325 MTKA BLVD. MINNETONKA MN. <br /> WATER SUPPLY <br /> Lake❑■ Well ❑ City ❑ <br /> BACKFLOW DEVICE <br /> AVB ❑ PVB ❑ <br /> Make 0 Model � Year of Manufacture � Quantity � <br /> Sprinklers: <br /> HUNTER 120 <br /> RAINBIRD 1800 <br /> HYDRAULIC CALCULATIONS Design Data: <br /> Area ofi Application: LAWN Sq. Ft. <br /> Coverage per Sprinkler: AS REQUIRED Sq. Ft. <br /> No. of Sprinklers: AS REQUIRED <br /> Total Water Required: 25 GPM GPM <br /> PERMIT FEE CALCULATION <br /> l. Permit Fee: $ 35.00 <br /> 2. State Surcharge $ 5.00 <br /> 3. Mail-In Fee $ 2.00 <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 /> t�> - <br /> Applicant :ij�_ a��,�.,,,�, Date � �� /� - // <br /> ........................................... ........ .................................................................................................................................................................. <br /> Approved �� Approved with Corrections Denied <br /> � � <br /> Revic��ed 13v: �' �� Date C �� �� <br /> Resefi Form <br />