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09/02%2015 14:31 FA1 �J52�J�3504�J CULLIGAN bitiTIiA C�004
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<br /> Zf abo�ve does not appIy;folIow guidelines below: � -
<br /> 1_ COI�TTRAC'I'�'�LTCE *is 1.25%o�contract pricc with a(11'�inimum Fee of g5Q.00)
<br /> x.O1ZS $
<br /> (canGact pricC) (mi71I11UITl$�D.00)
<br /> 2. ST,�#T�SC%12CHARGE '''"Add the Statc B[dg Code Div.Surchargc(A�Iinimum Fcc of 55.00)
<br /> x.0005 $
<br /> {conRoct pYiGe) (minit11U�17$ 5,00)
<br /> 3. P�STAGE&HA?VDLING(Only on Mail-In Applications) � 2_00
<br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��-0 U
<br /> ■ * COhTRACT PWC� or JOB COST means the actual or estimated dollar amount charged for the
<br /> permitted worlc including materials,labor, profit,and othcr fixed costs. Yt is the amounY to be charged
<br /> co the customer for the work done, (P any matenal, oquipment, labor or installations are fumished by
<br /> the owner,tenar,t or any other pariy, the reasonable market value of such itcros 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 requesi the s'ubrztission of a sib ed copy of the actual contrao�.
<br /> ■ '�*The STATE SURCHARGE IS ,OOOS of the contract price undet$1,OOQ,000 or$5.D0—whichever is
<br /> greater_ For valuaYions o�ei'$1,000,000 caIl thc Building Department at(952)249-4600 for the price.
<br /> s ,, �S.�U��B1�7G�BRlY1Z��,A���`��LA-'�'Ii�I�.T��AGREE1vx�:� �a . '�,,i`�„w�i�t4;�� �',�'�
<br /> T1�e undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
<br /> wor}: 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 applieati�n are complete, irue and
<br /> correct.
<br /> Applicant's Signature: Date: l' a- ��
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