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07/16/2012 14:37 FA% 9529335049 CULLIGAN MNTRA [�004 <br /> ... �.F .! • . . <br /> �y ti �� � T'�i'f ::-3�. <br /> t �.� �ir,•v��.. <br /> If above does not apply;follow guidelines below: � <br /> 1. CONT CT PRICE *is 1.25%of contract price with a(Minimum Fee o!$50.00) <br /> � x.O125$ � ' <br /> (oonaact price) (minimum 550.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Miatrnum Fee otSS.00) <br /> x.0005 $ ' <br /> (conuaccprice) (minimumS 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) S Z.00 <br /> 4. TOTAL PERMI7'FEE(Add T.ines 1-3 Abovc) S a� -0�1 <br /> ■ * CONTRACC PRICE or JOB COST means the actual or estimated dollar amount cherged for tfie <br /> permitted work including matorials,labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the worlc done, If any materiaf,equipment, labor or installations are fumished by <br /> the owner,tenant or any otha party,the reasonable market value of such items must be added W the <br /> . est9mated cost or contract price for pennit fee purposes. ln tho event that there is a dispu� on the <br /> smount of the job cost,the'City may request the submission of a signed copy o�the actual contract. <br /> ■ **The STATE SURCHARC3E is.0005 of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. For valuallons over 51,000,000 call the Building Department at(952)249-4600 for the price. <br /> � The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statemants made on this application are complete, true and ' <br /> correct. <br /> Applicant's Signature: Date: �] ' �� - I� . <br /> w � <br /> � 3 <br />