|
02/09/2015 14:a6 FAX 9529�a5049 CULLIGAN MNTKA f�007
<br /> �ji;;'I�.K��l,,�i k1.4p��iie 1 `'���+��11f y—� ��1��i� ' '� S i a � - ,�,',a„�Y� �y fc 1 } �„'ry''Kui�.�p:n,,.��'e vi'�1�"�i�l„
<br /> �f 1; ,`�r'� j�j' � �`[7 ,�����'{ �,��(�`r�y{� �{ + (?/� Q� r(� �Ic c hr
<br /> ,�,1i���; ':�,;i).� �'�ti�,nr�L�� l�� '�7�fJ_'i��1��1�:51,:.r�l,����JnV,��,4T1',� ::�-f, �D�+�,i1J.c��C��iDS',�11.�.V,�,'�i1�d:r.y�4„-C.;����ir�6��t�,;' ,�n G
<br /> Tf ahove does not app[y;follow guidelines below:
<br /> I. CONTRACT XCE "is I.25%of contract price with a(Minimum�'ce of�SU.00)
<br /> x.0125�
<br /> (Contruct price) (minimum$50,40)
<br /> 2. STATE SURCY�ARCE '�"Add the State Rldg Cod�Div_Surcharge(Minimum Fec of$5.00)
<br /> x.D005 �
<br /> (wntracrprice) (minimum$ 5.ao)
<br /> 3. POSTAGE&HAN1aLING(Only on Mail•In Applications) $ 2.00
<br /> 4. TOTAL r��MIT F'EE(Add Lines I-3 Abovc) $ p�a, u(�
<br /> ■ '' CONTRACT PRICE or JOB COST means thc actual or estimat�d dollar a�noont charged for the
<br /> permiteed work including maeerials, labor,profit,and othcr fixed cosu. It is thc amount to be ehargcd
<br /> to the custAmer for the work done. If Any materiaJ, equipment, Iabor or installations arc furnished by
<br /> the own�r,tenant or an� olhcr party, thie rezsonable market value of sueh itcros rnust be added to the
<br /> estimated cost or contraet price for permit fee purposes. In the event that therc is a dispute on Chc
<br /> amount of the job cost, the City may requEst the submission of a signed copy of ihe aotual contract.
<br /> ■ *'�The STATE SURCHARGE is.0005 ofthe eon�act price under$1,000,000 or$5.00—whiehever is
<br /> greater, For valuaClons over$1,OOO,b00 call th�Building DeparCment at(952)249-4600 for thc price.
<br /> �;��(y�y� r�h��1',y,• Ni ���r i,w!tu�N� � ,5� t �,.�:, in P ' i
<br /> �fMs i���' d� r � � c 'i i � C 7 ,ia ,v,,r,,� �� �.�
<br /> �.��, :� ;� ,rJa� ��.,,f��.��,r�� ����� ;����pL c��r����; ��� ,,,w.,�����-�;,�„�,,,.z,�,�.��s�r��:.��.,�,,
<br /> The undersi�r►ed hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
<br /> work in strict accord�nee with the ordinances of the Ciry and the regulations of the State of
<br /> Minnesota, and certifi�s that all statements made on this appIicAtion are complete, true and
<br /> correct.
<br /> Applicant's Signature: Date: a"� ' �
<br /> ,�;
<br /> y C'�G, Pv�'i:
<br /> ' ' ' " "F�o"r�;,
<br /> , ��.
<br /> I�C�Il'iw�a�nei!7,1��'��;riz!'!;W,P:'.i•..i
<br /> 3
<br />
|