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4' ` r � <br /> �t1 .A f,� +�J�l �� C i .�) 1 � F A�; ' 1 ft <br /> �r;Y„;xre;�.5'.b�`"�F�,�.+.�s�yf,,�tL�i�,��,;��r��"'� '�k" "� <br /> 1. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$50.00) <br /> � ��, ��'i� X.oi2s$ �—�D � �' �l <br /> �(contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE � �� ��� x.0005 $ �r `��� <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2•� <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ �'Z t '�� <br /> • * CONT'RACT 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 <br /> to the customer for the work done. If any material,equipment,labor or installations are furnished by the <br /> owner, tenar►t or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or conuact price for�ermit fee purposes. In the event that there is a dispute on the amount <br /> of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> "��� . . �. . ,. , �q,, , y . , .. . ;.- .. . �,�saf:�.p7 Slsj{�':'p � ( F��, <br /> ��, n �,; � �' uy r ,:: .. „ ., . , u,.��1 , <br /> � ' �, y u �i. � u",�,il� ,,q <br /> ,��c�.m.'� � ���� „ <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordin f the City and the regulations of the State of <br /> Minnesota,and certifies s t ma on this application are complete,m�e and correct. <br /> .;�^" <br /> Applicant's Si Date: ��""��"�!� <br /> 3 <br />