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07/10/2012 14:38 FAX 9529335049 CULLIGAN MNTKA 1 j004 <br /> .0 n47�ie,'rd nG{t'7 i��..n ,.�� :p�`rHt,. ._ .�I �, •ci.,, gi�'� :r� t�•i'ff��.,41x:`d�y�rrr .:�1e <br /> Y.{�.l'ftf�n.,..A_: ;� )�•'�N,y:.��� �?^T.':t l � .,s �. .> �.:.i �'ffr,�r.,i'.�o,i•�";b... <br /> If above does not apply;follow guidelines below: <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 **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00) <br /> x.0005 $ <br /> (contract price) (minimum$ 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2,00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 00! �U <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 <br /> to the customer for the work done. If any material, equipment, labor or installations are furnished 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 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 /> • **The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. <br /> 5:, 1!?q ;$,.. 1 � <br /> :tl t� n�7,r h ��� dl ��iit3(��j�l{b ��'i �w ��� '.y`, � �a� b ' �f <br /> h+cr� t���t..<421G.� .R��},r�„w.�. t,�,.d..,,�..G ,�r.�,:...°�.,..�.�.95.. �„ �. i- Y r��,•�.. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> C. <br /> Applicant's Signature: it. <br /> Date: I - <br /> 3 <br />