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07/12/2011 13:51 FA% 9529335049 CULLIGAN MNTRA C�004 <br /> � : <br /> ;.:`;`. �,:: :;�.:.�,E�1�'.,���.E�.0 _,,=TS�71�'� '`:JO�S�.(�'�.'�R:;�'S�'AA:��=�.,:;��:-r � <br /> If above does not apply;follow guidelines below: <br /> I. CONTRAGT PRiCE *is 1,25%of contract price with a(Minimum F�oi 550.00) <br /> x.0125$ <br /> (con0'ect price) (minimum 550.00) <br /> 2. ST��'E SURCHARGE **Add the State Bldg Code Div.Sutcharge(Minimum Fa of SS.00) <br /> x,0005 � <br /> ' (oontract price) (minimum S 5,00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT F'EE(Add Linas 1-3 Above) $_ o�e� •�� <br /> ■ '� CONfRAG"T PRICE or JOB COST means the actuat or estimated dollar amount charged for the <br /> permitted work including materials,labor,profit,and other fixed costs. It is the amount to be chargad <br /> to the customer for the work done. If any material, equipment, labor or installations are fumished by <br /> the owner,tenant or any other party,the reasonable market value of such items must be added to the <br /> . estimated coat or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job eost,the City may request the submission of a signed copy of the actual eontract. <br /> • **The STA7'E SURCHARGE is.0005 of the contract price umder$1,000,000 or$5.00—whichever is <br /> greater. For valuations over$1,000,000 call the Building Deparbnent at(952)249-4600 for the price. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Pettnit, agrees to do afl <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this appliaation are complete, true and <br /> correct. <br /> Applicant's Signature: U Date: �' �c� ' �( <br /> ' ,��� ,a.� :J � <br /> 3 <br />