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X'1 BRUIT FRIE rALCULATA . <br /> 1. 1.25% of Contract Pficr* or I . I' u c • t t <br /> f<{ (%. ,-_t' x ,0125 $ __ 613 <br /> (contract price) <br /> 2, Statc_Surchargc. ** Add the State building Cudc Division <br /> • <br /> Surcharge to each permit• x .0005 $ :2•,,25-___ <br /> (contract price) — <br /> ' or $.50, whichever is greater <br /> 3. postage And IIandlhog (Only mail-in applications) <br /> 4. TOTAL PERMIT FEE1,SO__ _ <br /> (Add lines 1-3 above) $ 9 <br /> * CONTRACT PRICE or JOU COST rnc,ws the actual or estimated dollar amount charged for the pet uiucd <br /> work Including materials, labor, profit, and'other lied costs. It is the tuuuuut to ha Chiu gcdl to the <br /> customer for 11w work dune. If any material, equipment, labor,or installation arc famished by the owner, <br /> tenant or any other party the reasonable market vtdue of such items must be added to the cuinnaicd cost <br /> or contract price for permit fee purposes. In the event(hat there is a dispute on the amount of the job cast, <br /> the City may request the submission of a signed copy of the actual cuulracl. <br /> ** The STATE SURCHARGE 15 .0005 of the contract price under $1,000,000 or $,5(1 • whichever is <br /> greater. For valuations over$1,000,000 call the Depautrncnl of Inspectional Services fur the (,nice:. <br /> { The undersigned hereby y applies to the City for issuance of a Plumbing Permit, agrees to du all <br /> work in strict accordance With the ordinances of the City and the regulaliurls of the State of <br /> • Miuncsota, and certifies that all statements made on this application arc complete, frac and <br /> .�; correct. <br /> II <br /> ! Applicant's Signature: iA)i-e-et-' ______ Date: &r. 1/5--Cr <br /> __ <br /> . <br /> • <br /> • <br /> • <br />