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9/01/11 D8 : 21AM CDT Spring Plumbing LLC –> Building Dept 9522494616 Pg <br /> 4 <br /> F88'C S Sam 509,00. '. <br /> Tf above does not apply,follow guidelion below; <br /> 1. &WUAC1LM= *is 1.25%of contract price with a(Minimum Fee of 850.00) <br /> 22,250.00 x.0125$ 278.13 <br /> (O0 — prim) "Wain ssae�oi — <br /> 2. STATE SuRCHARGE 22,250.00 <br /> X.0005 S 11 .13 <br /> (Commix ) <br /> 3. POSTAGE k HANDI.INC3(only an Mail-1n AppUcations) s 2.00 <br /> 4. TOTAL PERwr FEE(Add Lines 1-3 Above) $289-215 <br /> • + CONTRACT PRICE or YOB CAST means the actual or astiraated dollar Amount charged Por the <br /> permitted work includiew materiels. Mor.profit,and other fixed coats. It ir,the amount to be charged <br /> to the customer for tho work done. If any material, equipment,labor or installations two Tuan jbed by <br /> the 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 these is a dispute on the <br /> Mount Of the job cost,the City may request the subtrtiesion of a signed copy of the actual contract <br /> LJ :IN APPOCATiomAG NT <br /> The undersigned hereby applics to the City for issuance of a Plumbing Permit, agrees to do all <br /> work in strict omordance with the ordinances of the City and the regulations of the, State of <br /> Mitmosota, and certifies that all statements made on this application arc complete. true and <br /> conva. <br /> Applicant's Sigs>ztlltre; Date: <br /> 3 <br />