Laserfiche WebLink
09/.23/�010 12:00 FA% 9529335049 CULLIGAN �NTKA f�004 <br /> �''l:W.�°jJ�'''��''".•+:"•�•�y,:y.' i `.'t:• �� ,y�i �� . .V��F�`Ft�'�Y:7�i�.:l�:;/"zl:•�� '�1 <br /> .''��.i .1.�L••, .%;l,�� •m�r. �. <br /> If above does not apply;foUow guidelines below: ; ' ': � <br /> � <br /> 1. CONTRACT PRiCE "is 1.25%of contract price with a(Mit�imum Fce oi$50.00) <br /> , x.0125$ <br /> (canQact price) (minimum S50.o0) <br /> 2. STATE SURCHARGE **Add the Statc Bldg Code Div.'Surcharge(Mioimum Fee otS5.00) <br /> x.0005 $ <br /> (conuect prics) {minimum S s.00) <br /> 3. POSTAGE 8c HANDLING(Only on Mail-In Applications) $ �.DO <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S ��•� �� <br /> • � CONTRAGT PRICE or JOB COST mP�s the actusl or estimated dollar amount charged for the <br /> pennitted work including materials,�Iabor,pro�it,end other fixed costs. Jt is thc amount to be charged <br /> to the customer for the work donb, If any material,equipment, labor or installations are fumished by <br /> the owner,tenant or any other party,the reasonable matket value of such items must be added to tho <br /> . estimated cost or contract prico for ptrmit fee purposes, In;the eve�that thero is a dispute on the <br /> amount of the job cost,the City may request the submission of a signed copy of the actual contract. <br /> ■ **The STATE SURCHAROE is.0005 of the contract price under�1,000,000 or$5.00—whichever is <br /> greater. For valuations ove.r S 1,000,000 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 statements made on this application are complete, true and <br /> correct. <br /> , �- a3 - �o <br /> Applicant's Signature: Date: <br /> ; <br /> . I : : <br /> 3 <br />