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ll/2.1/2�d111 16:24 FAX 9529335049 CULLIGAN MNTKA C�004 <br /> • _... . .. . <br /> .�=: .:,..... _ ,,.P��.�,���;`c�cc�;a�co�r s ��:-:roB�avER:��:oa:on,.;; ';;?= ; , . . <br /> Tf above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of 550.00) <br /> x.0125 $ <br /> (contract priee) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div, 5urcharge(Minimum Fee of 55.00) <br /> x.0005 $ <br /> (contract price) (minimum S 5.00) <br /> 3. POSTAGE&HANDGING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � 010� . 0� <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit,a�d other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, labor or installations are fumished by <br /> the owner,tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for per►nit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the Ciiy may request the submission of a signed copy of the actual contract. <br /> • **The STATE SURCHARGE is .Q005 of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. <br /> y u J . b' . . �... �. .,l' (�"1. A <br /> t� yn <br /> 4� u:i i. 1 � �,, � �a.'; i. 1, ti;i:' �S r �'k: �'� r�i�t� � �� <br /> ' ;�;1 i ��i� 4.l 'u�"'�a� � i '° -�n� ;,}'i� y .n �d �,•�ts�?j'..a�'.'it��.�j'r � <br /> �. �`.� +, 4'�J ',,, �� .,�.: � :�, .s ,� ,s� ,��..ti� ,i;,... <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 regulations of the 5tate of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's 5ignature: Date: �� ' �f� - �� <br /> dh P <br /> Rese�t Fi�irm"' <br /> 3 <br />