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10/11/2010 12:48 FAX 9529335049 CULLIGAN MNTKA 1�004 <br /> ,.,., . . , ,.. ,. <br /> ..7! ".I:�..Clhi: l.t..� �,.fi �A`K� (� :cY. I� ��!'� !< �(�`%�il':<f_r::>�..I'�i':at <br /> %:�..�::r'�' ���_��. .,li'. V' ,�' �,� :1�,�`;�1.. 7.i",,'�L,ii <br /> ,;r;�: ,'r:= =P��'.�`���.����i��'r'��T�T .f���.��� :��>04;: Q <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of 550.00) <br /> x.O125 $ <br /> (contrect price) (minimum$50,00) <br /> 2. STATE SIJRCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee ofS5.00) <br /> x,0005 $ <br /> (contract price) (minimum$ 5.�0) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �a ' �`� <br /> ■ * CONTRACT PR10E or IOB COST means the actual or estimated dollar amount charged for the <br /> permitted work incfuding materials, labor,profit, and other fixed costs. lt is the amount to be charged <br /> to the customer for the work done. If any material, equipment, fabor or installations aze 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 SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. <br /> � �" �� ,�. s s, .. <br /> .1{ ;I' _ ..2 .u .r I ''i <br /> The undersigned 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 /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: � Date: I u ' �I ' �� <br /> F�eset,Fcirm <br /> 3 <br />