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12/21/2011 13:41 76378e9081 PLU BING SERVICES IN PAGE 05
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<br /> Tf nbovc dooc not appl.y; fpllow guidclines Luluw:
<br /> 1, CONTRACT PRIC.�+ *is 1.25%of contrac� t' e with A(.Minimum Fee of$50.00)
<br /> ���� x.0125� Id�� +U�
<br /> (contraat pri e) (minimum$50•00)
<br /> 2. STATE SIJRCHARGF �Q��
<br /> � x ,000s � `�� Z 3
<br /> (conhacG pri ) — "�
<br /> 3, POSTAGE&iTANDLING(Only on Mail-In Ap iieations) � ,. 2,00
<br /> 4. TOTA,�.,PERMTT�E�(Add I,.ines 1.-3 AUove) $ � �I ,�b
<br /> • °" CONTR�ICT PRICE or ;fO.B COST means the actufll or estimat�d dollar amount charged for the �
<br /> pc�initted work including matcriafs, l�bor,profit,and otl� fixecl �ntts, It is thc smounc to bc charsod
<br /> to the customcr for thc work d�ne, l.f any materi�l, cqui men.t, labor o.r, in.sCaliations arc furnishec{ by
<br /> the owncr, tcnant or any otl�er party, thc reason�iblc marl et vA)ue of such iccros must bc �dded to thc
<br /> esnmated eost nr conr.rar.t�,rice for permit fcc purpoeos. In the cvcnt ch.At thcrc is a.d.isNut� uii t��c
<br /> lmount of the jpb eost, the Ci,ty may request Che submis ion of a signed capy nf dte t►etual contr��l..
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<br /> Tl�e unfler,i,gned hereby a.pplics to kb.c City fui i.��uan�c oT a Plu.mbing 'Pcr.mit, agrees tq do alJ
<br /> work i.n. stri.et aeco.rdance wirh th.e ordinances of the C'ty and the rcgu]a.tions of tl�e State of
<br /> Min.nesota, aud certi�fy,es that all. seatements made ou t 's a�plication ar,e com.plete, lnze and
<br /> corrcct.
<br /> Appli.ca:nt's Signatur.c: Vl.� (ti � Dalo; � � Z� " 2-� 11
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