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� -_. .._.._ t-, ., .� ,. _..� .. ,.,, .,, ,., ,....,, �, ....�, ...... .....,�� <br />' ^ •. <br /> � ' ' A N <br /> 1. �,�5% of�'��.�,..P '�e* ar Mln� rai ��(S�S.04) <br /> �� - x .Q12S � � O� <br /> (contract price) <br /> 2. Scat�e Sun c� arQ�, *'" Adci the State �uilding CUd� L7ivision <br /> SurGhargc to esch permit. c1��1 x ,OQQS � a •�'0 <br /> (contract p�icc) .�^.� - --�-- <br /> ar $.50, whichever is greater <br /> 3. Pus ag�_ana_� � dli (�?nly mail-in applicationsa $ � _ 1,�p , <br /> 4. TOTA.L P�,RMTT F�E (Ac�d ti.�es 1-3 abave) $ `�� <br /> '" �ONTRAC'T PRtCF or JOB CC7S'I r[ieuas thc aGtual or�stimated doltar�maunt chargcd for the permittcd <br /> �vark inch�ding xnatGrials, labor, profit, and othar fixed roscs. It is the aaaaunt to bc charged ro the <br /> customer f�►r ihG wo�k dane. If any material, ec{ulpmcnt, Itlbor, nr cnstallatioa at�furnJshed by tlie owncr, <br /> t�nant or any ocher garcy !he r�nsonablC market valua af such items niust t►� �ddtd ta the estimated cost <br /> nr contract price for permit fee purposes. In the evcat that thcr� is a dispucc pu the a�uount of the Job cast, <br /> tAa Ciry [nay request Ihe subrtussian of a slgned copy of the actual c��ntr�c[. <br /> ** 'Thc STAT'E SURCHARCa� is .OUQS of the contract pric� under �1.000,000 or $.50 - whichevcr is <br /> grcasor. For vuluationa ovec $t,(}Od,Q00 cail the Dcpartment csf]nspectional Services for the price. <br /> 'fhe urtd�rsigned hereby applies to thc City far issuanc� c�f a Plumbin� Permic, a�r�es to d� aIl <br /> w�rk in sirict accc�rdance with the ardinances of che City and th� re�ulations af the State of <br /> Minnesota, �ncl certifies that all statemer�ts mad� Qn xhis application are compl�t�, tru� and <br /> correct. <br /> � <br /> Appl�cant's Signature:' - _ __.Dat�; I O '1 � <br />