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��20-2009 04:21pm From-CITY OF ORONO +9522494616 T-862 P.003/003 F-144
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<br /> 1I$�' �f� Y i(�Iu�1��.�'�j1� �t�� II�%I �l,��I ,� I ''.I��i.f.�l I S t � 1� •i. �C� J` �tL'H I �i � � �I i� I1f I.i 7 � �+�� i.��
<br /> 1F� ,7 � �itl{,'+�I��iI i��� Il�lil � ��i�.�yi �,�y� �ll ,�!��� I�r � h jI'�I �} ffI,�� � 1� I,�I��, �I�
<br /> �,i �;����� r�I'-�,s�l}�`ll!i f���iixr���i�4131.��,N�I,'i:�,�1��1.� .�I�il�*i'r ,Tr, � +;I. ..W' �` �=rt'I�I'�1:�'r � �, 'i`��jI�H'li��I��li�I lu:�l�li<<���� �u�1 Ij����l'�!',llif����;,!.il'1��i�
<br /> � Yzs,this secrion applics
<br /> The rcplacernent of a Ttesidenrial fixnuc or appliance that meets all tI�ree of the followi���;requirements�
<br /> i. Docs not requu•e modificatiar�to elecuical or gas service.
<br /> ?, Has a t�tal cosc of$500.00 or less;excl 'n the cvst of the fixturn or ap}��iancc:$nd
<br /> 3. Is improved,installed or rE•placcd by rhe homeowner or licensed conuacrc�,•.
<br /> Skip nzxt secti�n,if this applics; Cost of pernut $ 15.00
<br /> State Surcharge $ _50
<br /> Mail-In Fee(If AppliCable) $ 2.00
<br /> Total 1'ermit�ee $
<br /> , ��,��.��� �f �(��(� J {
<br /> �.� � �. -.1 �i� �Mldlll .1�7nr,� �� ,l. .t�.i � .u '�"71jA N�����;���6���J���V;�Ij�i�l�I�'����{i1��lii
<br /> If above does not apply;follow guidelines below:
<br /> 1, CONTRACT PRICE *is 1,25%of con�rAct price with a(Minimum�'ee of$50.00)
<br /> �Db� X_o�z�$
<br /> (con�ract pricc) (i ninimum 55U.00)
<br /> 2. STATF SLJRC:HARGE '"*Add the Srazz 131dg Code Div. Surcharge(Minimum 1Fee of 5.50}
<br /> x.000s $ �-•b�
<br /> (C6t1VAC[priCd) 1i��inimum$ .SO)
<br /> 3. pOSTACrL 8r HANDI.II�TG(Only on Mail-In Applications) $_. 2.00
<br /> 4. TQTAL P�RMIT FE�:(Add�,ines 1-3 Above) $___,_ _�•��
<br /> ■ * CONTRACT PRiCE or JOB CQST means the actual or esrimated dollar am��unt charged for the
<br /> permitted work including macerials,IAbor,profit, and othzr fixed cosis. Tt is the anwunc to be charged
<br /> to tue customcr for the work done. If any materiai, equipment, labor or installat�ons are furnished by
<br /> rhe owner, tenant or any ocl�rr pariy, the reasonable markez value of such items rmist be added to the
<br /> escimatcd cost or conrrAct price for permii fee puiposes. In the event that rher: is a dispute on rhe
<br /> amount of the job cost, the City n�ay rcqucst the subuiission of a signed eopy oi thc actual cantract.
<br /> ■ **The STATE SU�tCHARGE is.00OS of rhe Building Departmzn[at(952)249-4600 for tlze price.
<br /> �� d li�'- �� !1�I I1 t� I k1 i i�' �� �tA=�.�i � I l , ' � I. � ' ��+:�Aill��li�_��'�f 1�,jri IIj jf�ZSt!�1 i l�i
<br /> 1: { ..I.,�� .r'l� �
<br /> The undersigned hereby applies to the City for issuance vf a Mechanical Pernlit, asrees to do all
<br /> work in strict accordance with the ordinanc�s of the City and the regulati��ns of the State of
<br /> Minnesota, and certifies that all statements made on this application are �:omplete, true and
<br /> correct.
<br /> Applicant'� Signatttre: ��� Date: �� J�
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