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09/20/2010 12:47 FAX 9529335049 CULLIGAN MNTKA �004 <br /> , „_.,rf...., _�N �( -�,y.�{�y� <br /> ����� ,i�;;i.� �'` ; '`� ,:+��,_ �,n' ��tt.� �ti c_ �,�7�� (� 'ii�C;1;,i; <br /> `'r.;��-.ai.� �e'a :f�'i �'.�11�� .����:�7��1�G':N�P11tf. ���1'�:V,l'Y�'. _ � <br /> , -..+.;, <br /> ,.; � r���•,_ <br /> .,- <br /> ;�.;;...:��.� �.� <br /> :.','s <br /> :a`.`�� <br /> .. .. . _ <br /> � <br /> t;.� <br /> :�:r ?.� _ Y,., y:j,`.,, �'t.v c <br /> If 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 price) (minimum 550.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee ofS5.00) <br /> x.0005 $ <br /> (contract price) (minimum$ 5.00) <br /> 3. POSTAGE&HANDLTNG(Only on Mail-ln Applications) $ 2.D0 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S o�. 0� <br /> ■ * CONTRACT PWCE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. [f 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 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 SUItCHARGE is.0005 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 /> i�` � � 7 t � :t. �:.31f-C�JJ..31�"iL�1V;14 t 4'�y';tf � '�d 'CIA!'F^i,F <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 certifes that all statements made on this application are complete, true and <br /> correct. <br /> ApplicanYs Signature: �� Date: 9 - ao - �U <br /> r .��� <br /> R�set �si'r � <br /> ._ �.��.r�^l�ititi <br /> 3 <br />