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02/04/L013 13:05 FA%�9529335049 CULLIGAN MIVTRA 1�J004
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<br /> If ve does not�ppty;foll w guidelines below: ',
<br /> 1. CO C1' RICE *is 1.25%of contract pri�e with a(1Kinimnm Fee ot S50.00)
<br /> ' x.0125 S
<br /> (wntrect prica)� (minimum 550.00)
<br /> 2. T SUR HAR E «'�Add the State Bldg�ode Div.Surcharge(1Minimum Fee of S5.00)
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<br /> I ' x.0005 $
<br /> ' (contrect price) (minimum S 5.00)
<br /> . POS7IAGE 8c NDLING(Only on Mail-In Appl�cations) $ 2.00
<br /> . : TOT�►L PERM�'I'FEE(Add�Lines 1-3 Above) � $_ o1a •V v
<br /> 02;04 OL3 13: �; T'y t' "��r' '� 1`I:LIGt �T�-T �1004
<br /> � � �COI�'�►ur�1t10E or JOB COS�`ineans �ie actua� r estimated dollar amount charged for the
<br /> F ' permitted wofk including materials, Iabor,prPfit,and oth fixed costs. It is the amount to bo charged
<br /> to the custortyer for the work dona. If any rt�aterial,equip ent, labor or installations are fumiahed by
<br /> the owner,tefiant or any other party,the reasonable merk value of such items must be added to the
<br /> . estimated cosk or contract price for permit fr.e purposes. In the event ihat there is a dispute on the
<br /> ' :..amaunt-o�th�-}ob-cost,.the_,Cig+..may.request the_subCt � -of a,sigaed coPY-o�the.actual.ea�ntxact.
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<br /> � • *"'The STATE SURCHARC3E is.0005 of the contract pri e under�1,000,000 or$5.00—whichever is
<br /> �i greaten,.�F�vale►ati.ons over,$q,000,000 cal!the Building epartment at(952)249-4600 for the price.
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<br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
<br /> work in=stric�a�coo�anee.witFi.the ordinances of tiie ty and the regulations of the St�tieC'of
<br /> Minnesota, and certifies that all statements made on is application are wmplete, true and
<br /> � correct. _ _, -- _ . .
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<br /> Applicaiit's Sigr�ature: � Date: a '��'^�3
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