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Dec 28 15 10:35a Water poctors 7635351805 p.3 <br /> / i i � i . , , <br /> I � � <br /> I <br /> � il <br /> PF,F�M1T Fb ALCUL.4TI N{$}'—,IpgS OVER$540.04 <br /> If above does notiapply;follow b d lines below: ! <br /> 1. COVTRACT PRI E * is 1.25%of cor�traet rice with a(�1ini i um Fec of S5D.00) <br /> � � <br /> x.Q125$ <br /> (coi trnci priEcl (minimum!T:O.f10) <br /> �� I i �I <br /> 2. STATF.SURCH.4 G�: �, f! ' <br /> Ii x.00OSIi $ <br /> � ---__ _ _ _— ---- <br /> {co�uac prihe) <br /> � ' , <br /> 3. POSTAGE&HAND IT�IG(O:�ly on Mai�-In Applications) ' $_ 2.00 <br /> ' �', <br /> 4. TOTAI,PER11{T F E(Add Lines 1-3 ��bove) $ <br /> I <br /> ■ * CONTRACT PRICE or J B COST means th� a tual or estimated dollar amow�t charged for the <br /> permit��d�ti'ork including ma ri�ls,labor,profit,�and��otfier fixed cosls. it is the amount to be chareed <br /> (o t(re customer fo�th� work o�e. If any mater�al,equipment, labor or instaqa�ions ara fumished b}� <br /> the owner, tenant or any oth rty, the reasonable�harket value of such�iten�s i�ust be added to the <br /> es[imated cost or contract p ice for permit fee pjurp�se�s. In the ev�nt tHat there is a dispute on tf�e <br /> amounr of the job;cost, the iry may request the�sub'm'ssion of a signed icopy of the actual contract. <br /> PLUM$IN ERMIT AP�' I; � ION AGftE��[ENT <br /> I i <br /> , i i ' <br /> The undersigned hereby appli the City for �ssuance of a Plumbing� Permit, agrees to do all <br /> work in strict accordance wit t e ordinances �f the City and thc rc�ulations of tl�e State of <br /> N]innesota, and' cer-ti�es that II statements ma�de io this applicatioii are complete, true and <br /> � <br /> correct, ! ; 'i <br /> , � I <br /> A licant's Si nature: <br /> pp g �� ' � Date: _ <br /> , , i <br /> � I <br /> � <br /> I I I <br /> i � i <br /> j <br /> � I <br /> I i I <br /> I <br /> I I <br /> II I <br /> I <br /> � <br /> j � 3 <br /> � � i <br /> _ � ; <br />