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c� <br /> o ;._........ .. <br /> 0 <br /> . ,3,� <br /> O ��....�,'-�."��'$����$r�� ��'e. � :� � _.. g§� "i=�ir.'.��%. <br /> Q _ <br /> _— _""_"_...... ...____— � <br /> a FIXTURE BShAT � 9sr 2No , pTHER FIXTURE BSMT 15T 2�"' OTHER ' <br /> � <br /> TYPE Floor Floor 'fYPE Floor Fbor � <br /> N ---.............._.___ 1 <br /> O Water Closet � � �- Floor Dreins � <br /> , <br /> : � ; <br /> 4t — ----..._ --- � = <br /> Lavatory � � `�- SewerEjector <br /> Bathtub � ; � Leundry Tray � <br /> I <br /> N 'Shower ----�-- -- � . � '7- !Washer � { <br /> .. ---..._..----.............._.____— ; ' <br /> M � KitChen Sfnk � ?Water Heater f ' <br /> r <br /> ._._......................._._.._ � ;. <br /> r pjsposal � Water Softener C <br /> � <br /> ----._.___._......_.....__._ ._- -- <br /> --__...._......._... _......_..._---- = <br /> N Dishwasher , J Wet Bar � f � <br /> � __..__.,...._....__..___..................._._� i <br /> N Silico�ks 3 Misceflaneous <br /> � -----__ _-------- i <br /> � <br /> � 1����1a�.':;�x .:�'�..���'k�'K ,?��3",a,..���; {r_;,`. �R?r'° �: � <br /> ,: <br /> u......._,_. <br /> 1. CONTRACT PRICE `is 1.25°r6 of oontract price with a(Minlmum Fee of 550,06) ' <br /> ,D l7ct � C� �Y, at7 x.0125 $ € - <br /> (contract price) (minimum$50.00) � <br /> 2. STATE SURCHARGE <br /> ����i J6`f•v� x.000S $ <br /> (contract priCe) � ' <br /> �.: .::;.` <br /> 3. POSTAGE 8 HANOLING(Oniy on Mait-in Applications) $ 2.00 <br /> 4_ TOtAL PERMIT FEE(Add Lines 1-3 Above) S <br /> �� 1 ' � � � <br /> ' CdNTRAC7 PRICE or JOB COST means the adual a esUmated dollar amount charged for 1he �: " <br /> permitted work including materials,labor,profit,and other fixed cosis. It is the arr�unt to be c�arged lo *: <br /> the customar for the work done. if any material,equipment, lahor or instaliations are turnished by ihe <br /> owner, tenant or any other party, the reas�nable ma�ket value ot such items must be added to the <br /> estimated cost or contra�t price for permit tee purposes. In ihe event that there is a dispute on the �.:.. <br /> amount of 1he job cost,the City may request the submission of a signed copy of the actual contract. �,': <br /> la'�.''T..�.�'�'a'.-$�'�;Sa',..��k.;"��.'�".KFR�A�.,��� i'.'.�.1�I.�. .s °��'' '.;•x. ,t ' s <br /> The undersigned hereby appiies to the City for issuance of a Plumbing Permit,agrees to do a!I work i� <br /> strict-accnrdance wilh the ordlnances of the City and the regulations of the Siate of Minnesoia, and <br /> certifies that al{staiements made on this application are complete,true and corcect. ' __ _ <br /> c�1 g . <br /> N Applicanl's Signature: c �/�� � � <br /> ���. /�"%"'��—_ Date:�_ . ,. ;' <br /> � � . <br /> n " " <br /> � BuildingOfficiaU Inspector. Dafe: ' ' <br /> - --_ <br /> � _. _ ____—� __ ___ —_ --- __ _--- <br /> � _ _ __ ______ <br /> � ' P�2 � - <br /> 0 ; ., -: <br /> ILI � <br /> LL � i. <br /> •t % b y <br />