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10/21/2011 17:14 7635311801 DEANS TANK INC PAGE 04 <br /> t'V-2000 01:23pe Fray-CITY OF MQ +6622414616 T-666 P•0031003 F-166 <br /> M' <br /> ❑ Xes,dtls wcdm applies <br /> The"Plec m of aZMWWd4LAZ=ML4MV=MdW t ASM all tlttee of the Mawioa saWkeunt3p <br /> 1. Deft require modi8ceeiea to electrical cr gas service. <br /> 2. Lias a 1 gL=of 3500.00 or less;Miudigg the coat of else lixaas opt appliamae:assd <br /> 3. Is improved,msmtled or replaced by the bomeow=or llcemed aomcaetor <br /> p next sx&C.if fts upphee; CM-1 of Pee mh S 15.00 <br /> stare Stl<tbasge 5 <br /> &U-11-In Fee(If Applicable) $ 1.50 <br /> Taal Permit Fee $„ <br /> I MEMO 1.31 11 <br /> If above does not aWV,Wow pidaliam wow- <br /> 1 PMCE 'is 1.25%of Caottaet pdw witb a(Miolmnm Pee of 535.00) <br /> �� ; so <br /> — x.0125S <br /> (eomnc%Peace) (mrnimueA f33 OD) <br /> 2. S'�ATE SURSUR a+e Add die Smm Bldg Code Div.Surcharge oftimaa Fee of 5.80) <br /> X.0005 S <br /> (MM”per) (ounlmum s .!o) <br /> 3. POSTAGE&HANDUNG(only on Marl-ter Applicaaoap) S 1.50 <br /> 4. TOTAL P$RMIT M(Add Lines 1-3 Above) <br /> *CON'xRACT PR=or JOB COST cocaine the aceul or esataatad dollar amount fttgad for the <br /> pa m umd wotic mchidmg mameiab,labor,pwflt,noel outer And cosec. It n the atnoaat to be ftgpd <br /> m the customeR for the work done. if any material,equ"not,labor or inefallaftw as'e fumb ed by <br /> rile ownm+cult or airy other party,the teasoneble mariaet valise of such items must be added to the <br /> to *mud cost or COMM pact for permit fee pWows. lin the eveat that dare is a dispate ou the <br /> aum m of the job cost,the City may regttebT the sa6tmi82i0n of a signed copy of ttte aerial con== <br /> ■ "'The STATE SURCHARGE h.0005 of the BuMgg Depatu=t at(952)249.4600 dor the price. <br /> The undmr ped herby applies to Ilse City for issm mft of a Mccbabical Permh,agrees m do al] <br /> work in slriet accoordam with the ordintmces of the City arid the rt:pMony of the State of <br /> Miswesom, and certifies +liar all stattamaits made on this application are contplcu, true and <br /> COMM <br /> o _ <br /> Appliamt's Sipawm: Date: <br /> 3 <br />