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j> ��2F`T�. ,� r r z�qT `t ny.m. t* y.`.r•+^ 4 .off -a- <br /> '. .x 3f"2 4k,F.,l„..='�`''n >..�*;� i �c:_:�^I ,�_ a e e 7 rr t,:.�:wy" ��`,..'� :.�„�•nvt.V„• -,':`9'�w:. 6 •;9! „'Y`�. .;.*ear•„._` <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> Lk-11-4A .Ue� x.0125$ Gct <br /> (contract price) (minimum S50.00) <br /> 2. STATE SURCHARGE <br /> °C.) x.0005 $ <br /> 1(contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> .4-2ma1 1-e at.., <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ Le 1 <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 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 amount <br /> of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> �.` ,7•�"�,� �P�.p" - G a a, x t 'a' �; as-ay ',F,c-,-.,p,a -c 'v ,tl "fit p� <br /> k ?. i'f:r=��e.'et . �l r <br /> 'raSY�3 � �•b.�,a.s:u.�..� .c..<,cum.,.�t..4,du..r...�t-..<cGr' ..'.�.r:�t-,•�,.<x _..s�.�:r,; - -.oc:s .:a..�:u�.. <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 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 correct. <br /> Applicant's Signature: `Q,Lucx vtt)Date: \113 111 <br /> 3 <br />