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JOB STTE
Owner's Name ��Y°��/��'� (v�V��q ti� Telephone Number L1� �" g�� I
M�g aaa�ess 1 �;��� C�o 1���i S �� ��n�� � o� � �
Sprinkler Contractor's Name ' Q�� ~-�n � Telephone Number �L)�����3 �
Contact Person ��,� �� o� r��,1�'
Mailing Address� 6� L � C ' �`^�W`e S� ����w� � •
`VATER SUPPLY
Lake�� Well City
i, BACKFLOW DEVICE
! . AVB N�F PVB ti' /a-
Year of
Make Model Manufacture uanti
Sprinklers _ i�1�-���- �Q�}� � �1 � � .rl�p�. �'° �`�v
-�
� 3 s_ TOTAL
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HYDR�t`7LIC CALCITLATIONS Design Data:
�'���2 Area of Application: f������ 11� � Sq. Ft.
Coverage per Sprinkler: `3s � r��''�} Sq. Ft.
No. of Sprinklers: � � � � � �-'2 `���•�
Total Water Required: �.3�� g - +��`'� . GPM
PERIVIIT FEE CALCULATION
1. Pernut Fee $ 35.00
2. State Surchazee $ .50
3. Mail-In Fee $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
;3 7. �c
The undersi;ned hereby applies to the City for issuance of a Sprinkler System Permit, agrees to do
all work in strict accordance with the ordinances of the City and State regulations, and certifies that
all statements made on this application are complete, true and conect.
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A lica � V- � � �
PP Dat �k I � � � � /
************************ * *****************************************************
Approved proved with Corrections Denied
Reviewed by: � �
�/� ���C� Date_ ( �-�-��� ��
CITY OF ORONO
APPLICATION FOR LA`VN SPRINKLER SYSTEM PERNIIT
GENER�L INFORMATION
1. You may apply for sprinkler system pernuts by mail (P.O. Box 66, Crystal Bay, MN 55323)
or in person at the City offices (2750 Kelley Parkway). Submit plans for review with this
application.
2. PERNIITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL TI�PERMIT CARD IS POSTED ON THE JOB SITE.
3. When any new construction or remodeling is involved, a separate building permit must be
obtained.
4. All work must be done in accordance with City and State Building Code requirements.
5.• Two (2) sets of working plans shall be submitted for approval to the authority having
jurisdiction before any equipment is iristalled or remodeled. Deviation from approved plans
will require permission of the authority having jurisdiction.
Workin�plans shall be drawn to an indicated scale on sheets of uniform size with a plan of
the site so that they can easily be duplicated and shall show the following data:
a. Name of owner and occupant. �
b. Location, including street address.
c. Point of compass. �
d. Location of septic system if applicable.
e. Source of water supply.
f. Pipe size.
g. Pipe location.
h. All control valves, check valves, drainpipes.
i. Name and address of contractor.
6. All work must be inspected (final). Ca11249-4600.
24-Hour Notice Required
INSTRUCTIONS Complete all items on this application. Incomplete applications will not be
processed. If you have questions, ca11249-4600. You will be notified by phone when the pernut
review is complete.