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� s <br /> r. . <br /> .. . ......... a ........ . . .. —-� <br /> � <br /> � <br /> f ; Pkt�31:�t�tllt��"fi�'3'�JRE������1N��ALL�Q. <br /> � FtXTURE BSMT 1ST 2ND OTHER FlXTURE BSMT 1sr 2"0 OTHER <br /> � -�ypE Floor Floar TYPE Fioor Floor <br /> g. <br /> Water Gloset Floor Drains <br /> l.avafory Sewer Ejeetor <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> � Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscetlaneous <br /> � � PEf�MIT�EE CAL.CULATI4N <br /> 1. CONTRAGT PRICE *is 1.25%of contract price with a(Minimum�ee of$50.flQ) <br /> x.0925 $ `-�� <br /> (contract price) (minimcam$50.00} <br /> ; 2. STATE SURCHARGE <br /> � x.0005 $ s Z-� <br /> (contract price) <br /> 3. POSTAGE$ HANDLING (Only on Mai1-!n Applications) $ 2.00 <br /> 4. TOTA�PERMIT F`EE(Add Lines 1-3 Above) $ °�'� <br /> * CONTRACT PRtCE or JOB COST means the �ctual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to <br /> the customer for the work done. If any ma#erial, equipment, labor or instailations are fumished by the <br /> owner, tenant or any other party, the reasonable rnarket value af such items must be added to the <br /> estimated cost or cantrac# price for permit fee purpases. In the event that there is a dispute on the <br /> amaunt of the job cost, the City may request the submission of a signed copy of the actual cont�act <br /> PLUMBING PERNlf'F RPPLt�AI"iON A�R�EM�N�'<' <br /> The undersigned hereby applies to the City far issuance of a Pfumbing Permit, agrees to do ail work in <br /> strict accordance with the ordinances of the City and the regulations of the State of MinnesQta, and <br /> certifies that atl statements made on this application are comptete,tnae and correct. <br /> ApplicanYs Signature: ��'�`'�--�- <br /> Date: ���� � ` o <br /> Building OfficiaU Inspector: � Date: <br />