Downtown Sprinkler Program

                                            Application

Instructions:

1. Review the Downtown Sprinkler Program Outline and Agreement.
2. Complete this application form and submit it by March 2, 2007 to:            Attn:  Kevin Doyle

                                                                                                                        City Hall

3. In March, if you are selected for the program:                                               PO Box 708  

a. Submit three (3) sprinkler system installation estimates.                     6^th East 6^th Street           

b. Submit the Downtown Sprinkler Program Agreement.                       Lawrence, KS 66044        

Owner Information:

1. Building Owner(s):   
2. Owner’s Representative(s):  
3. Mailing Address:     

4. Phone:           E-mail:    

Building Information:

5. Building Address:    
6. Basement:             Yes

  No

7. Building Width:        Frontage Feet (Typical:  25’, 50’, etc.)
8. Mezzanine:            Yes      If yes, what is its use?   

  No

9. Number of Upper Floors:             (above street level)                                                              
10. Current Use of Building:           Main Floor:    

                                                   Basement:    

                                                   Upper Floor(s):        

Sprinkler System Information:         

11. Does the building currently have a separate fire sprinkler service line?

  Yes         If yes, what size?           Inches

  No

12. Is the building partially sprinkled?

  Yes         If yes, what area(s) is sprinkled?         

  No

13. Would you consider sharing a Fire Sprinkler Tap and Service Line with adjacent buildings?

  Yes         If yes, have you agreed to share a tap and service line with an

  No           adjacent owner(s)?  Please list below:

                                                      Building Owner(s):      

                                                      Building Address(s):   

Program Information:

14. Do you wish to receive the tap incentive even if you are not selected for the full system incentive?

  Yes, I plan to install a sprinkler system even without an incentive.

  No, please remove my application if I am not selected at this time.

Questions:

Please direct any questions to Kevin Doyle at 785-832-3410 or via email at kdoyle@ci.lawrence.ks.us.