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11/ /200� 11:11 FAX 9529335049 CULLIGAN MNTKA [�004 <br /> -� � . <br /> i <br /> ,y�i,. .,.�y ,.IC�� `�r- ,:j:,�t - - -,,: .i;,.�:;Jp�; rfi2�i.��;;�,.t,?t, <br /> ���� ,,�.='�,,:;,:., ;,�.:�;:�-�;P��.��:rE��c�cviA�ro�r ���-T�B:s �v�.�sao:Ao k�w � : , <br /> If above does�ot apply;follow guidelines below: <br /> I. CONTRACT PRTCE * is 1,25%of contract price with a(Minimum Fee of 535.00) <br /> x.0125 $ <br /> (conVact Price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minirnum Fee of 5.50) <br /> x.0005 $ <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&I��ANDLING(Only on Mail-In Applications) $ .�� o�•V U <br /> 4. TOTAI.PERNdIT FEE(Add Lines 1-3 Above) S �7 �SV <br /> ■ * CONT�ACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, tabor,profit,and other fixed costs. It is the amount to be charged <br /> to the cu$tomer for the work done. If any material, equipment, labor or installations are furnished by <br /> the owner,tenant or any other pautyy,the reasonable market value of such items must be added to the <br /> estimatec� cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> a�nount 9f 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$1,000,000 or$.50—whichever is <br /> greater. �'or valuations over$1,000,000 call the Building Department at(952)249-4600 for the price, <br /> 1 y�#. ;n`i�.l;��,y��i��l .r� �y li d:t"t,"; .'2�� - � t�i'#'1?.� 11.��'�4Q��{�rv���y�r��-�l��l�'���IY f�(� i Y:j�)� <br /> ! i ,i. �%_. r��4n_ <br /> The undersi�ned 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 /> Mumesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> I . Q <br /> Applicant's signature: Date: ��"�� � I <br /> � �`�1�;:,��'' ����� <br /> , . '� �r� <br /> 3 <br />