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07/03/2013 12:45 FA% 9529335049 CULLIGAN �NTRA C�004 <br /> }.� 'f� :,y.,h:.,: ,:w.;�1 • <br /> F �ih,`'���F'� ,.`� � }. _ •1xl �.��'.���,�;e •,�'��'1.V'i�Js�t•iti:l�'!1'',j. '.� �I�e <br /> t'iit�,#,'-v«'.'���';ii:•:.;;£a rr� ir, <br /> If above does not appty;foilow guidelines below: <br /> 1. C(�NTRpCT pRICE *is 1.25%of contract prica with a(Minimam Fee of$50.00) <br /> x.0125$ <br /> + (contract price) (minimum$50.00) <br /> 2. STA'l�SURCkIARGE **Add the State Bidg Code T7iv.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•0� <br /> 4. TUTAL PERMIT F'EE(Add Lines 1-3 Above) $ aa• � � <br /> ■ * CONTRACT PRICE or JOB COST means the ac�al or estimatsd dollar amount charged for the <br /> permitted work including materials,labor,profit,and other fixed costs. ]t is the amount to be charged <br /> to the customer for the work done. Tf 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 purpases. In tha event that there is a dispute on the <br /> amount of the job cost,the City may request the submission of a signal copy of the actuat contract. <br /> ■ *�'The STATE SURCHAR.GE is.0045 of the contract price under$1,000,00Q or$5.00—whichever is <br /> greater. For valuations over$1,000,000 cal!thc Building Department at(952)249-4600 for the price. <br /> , <br /> � � � _ <br /> The undersigned hereby applies to the City for issuance of a Plambing Permit, agrees to do all <br /> work in strict accordance with the ordinances of ttie 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 /> ' i nature: � Date• <br /> Appl�cant s S g <br /> a ,,. ., u . <br /> 3 <br />