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To: Page 4 of 5 2015-01-16 22:02:13(GMT) 17634452061 From: Mark Conner <br /> PERMIT'F�E�;AL�:ULATrt�l'�1(S)—.J(�$S C�V�R$SO�.U() --- <br /> if above doe�noi�tp�l�; follow guitlelincs beluti�; <br /> l. CONTR�CT PRICE *is i.254�u of contract price wiEh a(Mini�num�ee of'�SO.OU) <br /> �dA`7� x.0125 $ �c�.�� <br /> (conuact pnce) (minimum 650.00) <br /> 2. STATE SURCH.ARGE <br /> "��"? :� x .000s g � . �`� <br /> _ _.--- <br /> (conGact p�ice) <br /> 3. POSTAGE&HANDLING(Ouly on Mail-In Applications) S 2.E�� <br /> 4. TOTAL P�.12i'l1IT FE�(Add Lines 1-3 Aoovej � � � ° �� <br /> ■ * CO\TR�1CT PRICE or JOB CUST i71eu1s the actuai or estimated dotlar amoimt cl�arged 1'or tlae <br /> pennitted work inch�ding mat�iials, labor,profit,anfl other Iixed costs. It is the amount to be charged <br /> to d�e customer'for the work�done. if ariy matez'ial, equipment,labor or insiallatioz�s are furiii�lied by <br /> tbc owucr, tcnax�t or any oflicr party,the reasonable market value of sl�c� items must bc added to the <br /> estin�atecl cost or contract price for pennit fee purposes. In the event that there is a dispute on the <br /> an�oimt of�the�job cost, the City may reqiiest the submfssion of a signed co�y of the actu�il contcact. <br /> .PLUMBING PERIVIIT?�PPLIGI�TION 11GI�EEMEI+TT : <br /> The undersigned liereby a�plies to the��Cit}� for issuance of a Plumbing Pen;�it, a�;rees to do all <br /> work in sh-ict accardance with the ordinances of tbe Cit} and the Y•egulations of the Scatc of <br /> N[innesata, and certifies That all stateiiients made on this application are coinpleie, tn�e and <br /> cuirect. <br /> �`'' ,-,� <br /> ,,.3� � ,%'��,..,,.--"^ <br /> Applicant's Signature: Dax�: � r s 15'� <br /> 3 <br />