|
Oa/19/2015 13:54 FAX 952fl3a5049 CIILLIGAN 92NTKA �00�
<br /> �,���sl"�}'�''�+'�, ' PE�f'.�;,F'$�,'G�,A�,',•'� � 1?T+41�T•�,"�"�;fJB,S„�QV�i���S�Q0A0`T'��-1�L;,+�r`L-:1�:���,� �'�.'r;1��4
<br /> ff above does not apply; follow guidelines below:
<br /> 1. CONTRACT P12]'C�' *is 1.25%of contract pricc with a(Minimutn Fee of$50,�0)
<br /> x.0125$
<br /> (contruct pricc) (minimum$50.00)
<br /> 2. STATE SXIRCHARGE �*Add the St2tc BIdg Code Div.Surcharge(Minimum Fee of$5.60)
<br /> x.0005 $
<br /> (cAntrnct priCC) (minimum S S,OD)
<br /> 3. POSTAGE&HANDLING(Qnly on Mail-In Applicatians) $ 2.00
<br /> 4. TOTAY,�°�RMIT FEE(Add N,jnes I-3 Above) $ • ��
<br /> ■ * CON7'RACT PRICE or JOB C�ST means the actual or estimated doIlar amount charged for tho
<br /> petmittcd work including msterials,labor, ptoft, and other fixed costs. tt is the amount to be charged
<br /> to the customer for the work done. If any material, equipmen� labor or installativns are fumished by
<br /> the owner,tenant or any other pa�ty,the reasonable msrkct value of such itcros must be edd�d to the
<br /> �stimated cost or eontract price for permit fee purposes. In the event that t�hcre is a dispute on the
<br /> amaunt of the job eost,the Cify may requtst the submission of a signed copy of the actual coniract_
<br /> ■ *"`The STAT'E SURC�iARGE is.0005 o�ihe eontract price under�I,000,000 or$S.DO—whichever is
<br /> greater. For valuations over�1,00O,OOp r,all the Building Department st(952)249�600 for the price.
<br /> Ia;K „ i �,�l�vn �p��yy. �^}j��,� I, °r! i i N,"^�' �,�w� I A I.( �ii ) r.
<br /> � � p r �s,�-� ',� � .�",�����AP�iL,�,�A��,�1�''A:Cr��]1� "�l �r, '�,t '�h�,,�p�"��.',
<br /> ���,��P�S��slfa..riL��l.,.a�'4��en.,�aap�II�r.L�. f I t � � �,IL J�:l�A.i ti� ��Z'�
<br /> �:
<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 State of
<br /> Minnesota, and certifies that al] statements made on this application are complete, true and
<br /> correct.
<br /> Applicant's Signature: l�ate: 3 - I� - I j
<br /> �,:,.,..�n.,�.,1F,,,;�,�, m�
<br /> ;.�Re � ,�i H d�'I��i{,
<br /> .�e , �
<br /> "lw!;�dr:����d�,:�c���V�,��•:�ir,��l:�a�
<br /> 3
<br />
|