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�� ,:�~ $�1�G,��'.��T �� � - ��� � ', � <br /> x � <br /> Uf�E ��1!C��11� T�l,�. . �� �, ����� <br /> � . <br /> �D° <br /> K� <br /> ., <br /> ._ � �; . � �; <br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER <br /> TypE Floor Floor TYPE Floor Floor <br /> Water Closet � Floor Drains <br /> Lavatory 2 Sewer Ejector <br /> Bathtub ' Laundry Tray <br /> Shower � Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> . � <br /> . . „,.. . ,, ,. . , . <br /> _5 dM <br /> �. , . .. . � . ,�_ <� .. <br /> 3r '�' ,e�' ,5 <br /> , . . <br /> . . �� � .� r'4 ` �f:_.. ).. z.'. <br /> ��. �. �, � � . ^ <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> ��(�� x .0125 $ <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3. POSTAGE � HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ �� �7� <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. In the event that there 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 /> � %*'� ..����� �� n �����I ��,-i��m{_�������� #� r�����1�,+���.��'��}^�S'� .T� ,w�b����$3:. 4 �:���, <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 ordinanc of the City and the regulations of the State of Minnesota, and <br /> certifies that all statements made o hi appli tion are complete, true and correct. <br /> ' re: Date: ( /� ��< � <br /> Applicant s Signatu <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />