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66/26/2611 22:02 7637535125 NOWTHEN PLUMBING PAGE 04/04 <br /> . <br /> PE�i'I'F�E:�;ei.LCtJLATTO.N.'S �=Jd.B�,:O��''$501J.O.Q .• <br /> !£abvve does not a.pply;fqllow guidelines below: <br /> �- ' NT. T P .1 '�is 125%pf contrac!'pricc wil;h a(Minirttorn Fce of$5p,00) <br /> 3,152.77 39.41 <br /> X.o�25 $ <br /> (eontr�et priee) (mioimuen$SO.OQ)^ <br /> 2- �TC SURC�IARGE <br /> 3,152.77 � 58 <br /> x .Q005 $ <br /> (contruct pr;cc) <br /> 3. POSTAGE&HA.NDI,ING(Only on Mail-In Applications) �_ <br /> z o0 <br /> 4. TOTAL PERMIT FEE(hdd Lines ]-3 Abo�e} �Je3.58 <br /> ' '� CONTRACT PR.fCF or JOB CQST metins Che actual or estimated dp�lar pmount char�ed f�r the <br /> permittcd work including materials, IAbor,profit, and other fixed costs. il is the a��tount to be charged <br /> to che customer for thc work done, if any material, cqutpment, labor or installations are furnished by <br /> the pwner, tena.nt or any othcr party,the rcasonable markel valuc of such items must be addcd to thc <br /> estimared cost or conYract price for permiC fee purpose9. In the �vent that thcre is a dispute on thc <br /> amount: of the job cost, the City may request the submissipn of A signed eopy of Zhe aeYual contract, <br /> PLUN(BX]�T�PERI�ITT'APP.L<TCA7'T�ItI';:;q,�''i1����MEN?'� <br /> The undersigned hereby applies to the City for issuat�cc of a Plumbing .Permit, a,grces to dc,� a1► <br /> work in strict accordance with the ordinances of the City and the regulations oF the State of <br /> Minnesota, and certifes that alf statements made on this application are complete, true and <br /> c��•rect. <br /> Applicant's Signature: d / <br /> � Datc: {O' 7i� , <br /> ....... . ..�....... <br /> Rp�s�et Ft�rm <br /> 3 <br />