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r w . <br /> � FERMIT F r,A�ULATI41!�(� <br /> 24t}Z State Statute �] YeS, � Section Applies <br /> The reptacement af a ReSidentia! fi�ture or ap�l�ance ihat meets aIi three of � �ollowing� <br /> requiremenLs: � <br /> 1) D s n require mod�cation to electrical or gas secvice. . <br /> 2) Has a taI co t vf$SOO,pp or Iess; e c u„�,.i�the cast of the fucture ar appiiance: <br /> and <br /> 3) Is improved, instatled or replaced by the hom�owner or Iiceneed contractor. <br /> Skip next section; Cost of Permit $ ��,�p <br /> Siate Surcharge � ,Sp <br /> Mai1 In Fee S 1.50 <br /> ------.--�—.�.. <br /> If above does not apply, folIow guidelines below; <br /> 1. CQntract Price'' is .4125 % of job with a ]1��.nirn�F�of�' ; OQ� <br /> -�� � x .0125 S <br /> (contract price) {iuinirmum$35.00) <br /> �• State S rch ge **Add the State Building C�e Division a {1Tznimmn gee of$ .SQ) <br /> �� � x .0005 S <br /> (coutract price) ���$ .$a) <br /> 3. Posta�e and Handti� {O�y mai�-in appiications) S 1.50 <br /> 4. TQTAL pERMiT FEE (Add lines 1-3 above) g <br /> * CONTRACT pRICE or 7UB COST meaas the actual or estimated dallar amcn�.c charged for the permitted <br /> work including materiats,tabar,groFt,a�i ocher fued costs. It is the amount ro be chazged to the customer <br /> for the work done. If any material,equipment, fal�r, or instailation azc '�'�ed by the own�r, tenant or <br /> any other party the reasonable market value of sucb items must be actded Eo t�� ��ated cost ar contract <br /> price for petmit fee pvrposes. In the event that there is a dispute on the amouni oi the job cost,the City may <br /> request the submission of a signed copy of the actual contract. <br /> ** 'Ti�e STATE SLJKCHARGE is ,00p3 of the contract grice under�t,Q00,U0p or S,Sp_R,hichever is greater. <br /> Far vatuations over$1,O�10,a0Q call rhe Department of Lospect�an Services far c�e price. . <br /> The urtdersigned hereby applies to the City for issuance of a Ptumbing Permit, agrees to do a11 <br /> wark in strict accardance with the ardinances of the City and the reguiatzons vf the State of <br /> Minnesota, and certzfies that aIl statements made on this application are complece, true a�d <br /> correct. <br /> w <br /> Applicant's Signature Date: �Z— Z� <br />