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� ' <br /> � �; r'���4 s.� r ��x'.` � �, �" '� �k�"����`���,`: <br /> „� o- �W <br /> FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1sT 2"o OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet � Floor Drains � <br /> Lavatory � Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater I <br /> Disposal Water Softener <br /> Dishwasher Wet Bar I <br /> Sillcocks Miscellaneous � <br /> �d�� � �au o,;,n <br /> � � �� � ��� e� fi # .;�. � � <br /> ,�5 9 ,.,� '� , j��'��,p'z�'�'��,,s '! � 'F '�`�`_i �,: <br /> ?,;.� "�%�� �3 a, <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> 7g� x .0125 $ ��. j3 <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> 7g�� X .000s � 3. 93 <br /> (contract price) <br /> 3. POSTAGE � HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ ( O—( . O� <br /> " CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to <br /> the customer for the work done. If any material, equipment, labor or installations are furnished by the <br /> owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. ir� ihe event that there is a dispute un fihe <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> � .� � � <br /> `� �� �,§` F� �x ���s >����rs,:�����.��. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in <br /> strict accordance with the ordinances the City and the regulations of the State of Minnesota, and <br /> certifies that all statements made on application are complete, true and correct. <br /> ApplicanYs Signature: Date: Z �Z 1� <br /> Building Official/ Inspector: � Date: �' �"� / � <br /> Page 2 <br />