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,9�/06:2012 04:45 7637535125 NOWTHEN PLUMBING PAGE 04/04 <br /> PERI�IIT FEE CAi;CULA'F`I01�T S -;TE�BS.�7VEI�$St��0:00 <br /> ►f above does not appiy;follow guidelincs below; <br /> l. ONT ACT Ri � *is ].25%of conCract price with a(Minimum Fce of$50.00) <br /> 5,000.00 62.50 <br /> X .oiiS$ <br /> (�ontrac�pricc) (minimum SS(L00) ` <br /> 2. STATE SUR HARCE 5�QOO.00 <br /> x.0005 $2•�0 <br /> (eonvact pricc) — <br /> 3. POSTAGE&HANDLTNC(Only on M,ail-In App(ications) g_ �,pp <br /> 4. TOTAL P,ERl1�IT FF,E(Add Lines ]�3 Above) $6��00 <br /> ' * CONTRACT PRfCF or 70B COST means the actua! or esCimated dollar amount charged for the <br /> permitted work including materials, labor,profit, and other fxed cosCs. Tt is the a.tltount Co be charged <br /> to the customer for the work done. 1f any materiaJ, equipment, labor or installations are furnished by <br /> the owner, tenant or any other party,the reAsonable market valuc of such items must be added to the <br /> estimated cost or contract price for permit fee purppses, In tha event thst the�� is a dispute on the <br /> amc�unt of the job cost, the Cily may request the submission of a 5igned copy of the actual contract. <br /> PLU1ViBa1�TG pERMfT A:1'PL�CATi`OIV ACrRE�11,�IE1�I' .. <br /> The undersigned hercby applies to the City for issuance of a Plurnbing Pcrmit, a�rees to do all <br /> work in strict aecordance with the ordinanees of the City and the regulations of tlZc State of <br /> Minnesota, and certifies that all statements made on this application are co�npiete, true and <br /> correct. <br /> Applicant's Signature: f Date: 02��6��� <br /> Reset,Form <br /> 3 <br />