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03/28/2012 12:39 FAX 9529335049 CULLIGAN MNTKA f�004
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<br /> If above does not apply;follow guidelines below:
<br /> l. CONTRA.CT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
<br /> ' x.0125 S
<br /> (convacc price) (minimum SSo.00)
<br /> 2. STATE S'URCHARGE ** Add the State Bidg Code Div.Surcharge(Minimum Fee of S5.00)
<br /> x.0005 $ '
<br /> (contract price) (minimum S 5.00)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicatio�s) $ 2.00
<br /> � 4. TOTAL PERMIT F'EE(Add Lines 1-3 Above) S �o�. ��
<br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the
<br /> permitted work including materials, Iabor,profit,and other fixed costs. It is the amount to be charged
<br /> to the customer for the work done. lf any material,equipment, labor or installations are fumished by
<br /> the owner,tenant or any other parry,the reasonable market value of such items must be added to the
<br /> e5timated 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 eopy of the actua) 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 caU the Building Department at(952)249-4600 for the price.
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<br /> The undersigned hereby applies to the City for issuance of a Plumbing�Permit, agrees to do all
<br /> work in strict accordanca 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: �3 -a g - ���
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