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06/O1/2011 13:18 FAX 9529335049 CULLIGAN MNTKA C�004 <br /> � , <br /> ,...,,..,..:.: <br /> ,:, :;,. :;,.: ; �: <br /> •;,-.�.�.... .. :_�PERIVIL'1'�E�;CAT':CT�I;�i:"TIQN:�.';J 10 S:QVL���$500:00':,:;:<:;.;.::; <br /> If above does not apply;follow guidelines beiow: <br /> 1. CONTRACT PR10E * is 1.25%of contract price with a(Minimum Fee of 550.00) <br /> x.0125$ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge{Minimum Fee of$5.00) <br /> x.0005 $ <br /> (contract price) (minimum$ S.QO) <br /> 3. POSTAGB&HANDLING(Only on Mail-ln Applications) $ 2.00 <br /> 4. TpTAL PERMIT FEE(Add Lines 1-3 Above) $ o�o�•�� <br /> � * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, iabor,profit,and other fixed costs. It is the amount to be charged <br /> to the castomer for the work done. If any material, equipment, labor or instailations are fumished by <br /> the owner, tenant or any othar party,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 request the submission of a signed copy of the actual contract. <br /> • "`*The STATE SURCHARGE is,0005 of the contract price undar$1,OQ0,000 or$5.00—whichever is <br /> greater. Por valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. <br /> {�y u..,.. �:..,.m��.�r a �#bs. 'a� #+�'�t!'. <br /> iSi7771i!�i��`.Iz�j�C�;k��''µ' i� '� 't.�»" ':���"''r!,��isJ'� i f:e� H ;f—�,�5� '� °:.i`•=!�tvi.:!�;:;'�� ,Y�.�rT,ht�A�� <br /> �js 3' <br /> The undersigned hereby applies to tha 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 State of <br /> Minnesota, and certifies that all statements made on this application are compfete, true and <br /> correct. <br /> Applicant's 5ignature: � Date: � ' �' �� <br /> F��°t.�;��tr�;�z+r��;�s��! <br /> ��te���'��o'r,m� <br /> 3 <br />