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0,4/�7/2014 14:16 FAX 9529335049 CULLIGAN MNTKA C�007 <br /> � <br /> �.� �";? , � , � � . <br /> _`1'E�v1I'�'FEE CAI;CULA.�'Z+C�N'S"':','J'�BS,bV�R$�40:p(�', , `�`: <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE *is].25%of contract price with a(Minimum Fee of$Sp.00) <br /> x.0125$ <br /> (contract price) (minimum$50.00) <br /> Z. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of 55.60) <br /> x.0005 $ <br /> (contract price) (minimum$ 5A0) <br /> 3. POSTAGE&HANDLIIYG(Only on Mail-In Applications} $ 2.00 <br /> 4. TOTAL PERMTT FEE(Add Lines 1-3 Above) $ �� ,p� <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimatcd dollar amount charged for the <br /> permitted work includ•ing matcrials, labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, Iabor or instaliations are furnished by <br /> the owner, tanant or any other parry,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 requcst the submission of a signed copy of the actual contract. <br /> ■ **The STATE SUl2CHARGB is.0005 of the conlract price under$1,000,000 or$5.00—whichaver is <br /> greater. For valuations over$1,Q00,000 call the Building Department at(952)249-4600 for the price. <br /> ,�. <br /> '��N°, � ,'� ,�� ' � .� ` � _ :��,� {� � <br /> 'x.�r 7 ,A�.��.�:�_T�" �& �,u �� "�' �' u.,,=:Aat�i',�s�4u�un.,!S-���'�.C;i,a <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 regnlations of the State of <br /> Minnesota, and certifies that all statements made on this apptication are complete, true and <br /> correct. <br /> � Applicant's Signature: g ' Date:�- � - ( <br /> ��_. r4������ +' <br /> �� r1� �r �: <br /> ���;. _������,�,; <br /> 3 <br />