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10/07/2010 08:32 FAX 9529335049 CULLIGAN MNTKA 1�004 <br /> w <br /> i:t";�`'� ( ��, � :��,3 .. �.�y� l� n ..�.:'..:;,. i�;J... <br /> y,�.7+ )�y��,��,p.y����c �.} �/,y�,{�(� a'J'.O",1�.ih�''}.,,:;�',i.�::.�'�:8'.r:'. <br /> `'i ::tr'P �.�' '�'��l�r '�AclV�:•� :.�1�����:�•':(�,'�+t�i�� �Y{l� 1^t'i':..,. <br /> �'3..�4:�� r.11-'�`''"Uh:`VY.�. <br /> If above does not apply;follow guidelines below: <br /> 1. CUNTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of 550.00) <br /> x.0125$ <br /> (contract price) (minimum$SO.DO) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div, Surcharge(Minimum Fee of 55.00) <br /> x.0005 $ <br /> (wntract price) (minimum$ 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ _ 2.00 <br /> 4. TOTAL PERMTT FEE(Add Lines 1-3 Above) S ��• �V <br /> � * CONTRACT PRICE or JOB COST means the actua) 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 fumished 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 purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> ■ *"`The STATE SURC}3ARGE is.0005 of the contract price under$1,000,000 or$5.00—whichaver is <br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. <br /> � € ��,� <br /> �. <br /> � �, .„ � `'''� ' � :� � .� �` ��.,. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all <br /> work in sVict 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 <br /> correct. <br /> A licant's Si nature: � Date: ��- � (� <br /> PP g <br /> Reset foi'rn,': <br /> 3 <br />