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12/11/2014 14:35 FA% 9529�a5049 CLTLLIGAN MNTKA �004 <br /> ,,�r �+ ��� I '�y��r � ,�+ . � +/�/'�'(��,���yy-���e�an.�,'� c�;��, <br /> �I '�'i`�7'����1.Za'��. I\i .mi �p�,� C� ��� �'°ltl��' �� � '�,V.Y'�!7�.v`"��Y� lklC.'�i����ti�,�,,��� _,�,�. <br /> ti4;� �� a�nV���R,� N7.rtiS,.-"•�, d-:i6`.,, c ,� <br /> If above does not appty;follow guidelines below: <br /> 1. CON'1'RACT PRIC� *is l25%of Contract pricc with a(MiDimam Fee of$50,00) <br /> x.0125 S <br /> (contrnct pCiCe) (min�mum 550.00) <br /> 2_ 3'I'p'I'E S RCHARGE **Add the State Bldg Code Div_Surcharge(Minimum Fee of 55.00) <br /> x.0005 � <br /> (con[s�i price) (minimum 5 s.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) S 2•� <br /> 4. TOTAI.P�RMTT FEE(Add L.ines 1-3 Above) $_ aa• �v _— <br /> ■ + CpN'I'RACI' pRICE or JOB COST means the actual or estimated dollar amount chEtrged for fhe <br /> permined work including msterials, labor,profit,and orher fixed costs- It is the amount to be charged <br /> to the customer for the work done. If any matcrial, equipment, tabor or installa�tion5 are furnished by <br /> the awner,tenant or eny other party,thc reasonable market valuc af sueh items must bo added to the <br /> estimated wst or contract price for permit fee p�nposes. In the event that there is a dispute on the <br /> amo�u►t of the job cost,the City may request the submission of a signed copy of the actual contract. <br /> ■ s�`The STATL'SURCHARGE is.0005 of the contrsat price under 51,000,000 or SS,Oa—whichever is <br /> greater. For valuations ovCr S 1,000,000 call the Building X7epartrnent at(952)2a9-4600 for the price_ <br /> ,�� ��� � �; �,� � �°�;;�����. �'�;� ���p�� �'"� ���„ �� G���;r`���r�;�,��'..:�w��� <br /> ant� �� �,�� ,� �� �"'� ��,iY'd,k�� �4.AY.YV��`nr'r�4 r.,n o�; <br /> 'The undersigned hereby a.pplies to the City for issuar�ce of a Plumbing Permit, agrees to do all <br /> work in striet accordance with the ordinanees of the City and the regula#ions of the State of <br /> Minnesota, and certifies that atl statements made on this appIication are complete, true and <br /> correct. <br /> AppIicanYs Signature: Date: �e�-I�� ��_ <br /> i��,q��,�'�i�����, • . <br /> 3 <br />