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�5��-��;m��'w 5�3"�f " r� re��.w . , ., __ - . . ....... .__ .. .. <br /> „y �*���;. _ <br /> .»..�— <br /> ;� �E�..�.�rr��� e��.c��.:�-��c������--�c��s ov��.�sc��.�o - �s �. �� : <br /> If abo��e does not ap�ly;follow�uidelines bek�u-: <br /> 1. CONTR�CT PRICE * is 1.25°ro af contz�ct grice«�ith a(��inim�m F�ee of�50.00) <br /> ���,,/ c,t� <br /> 7���L`�G'� x .0125 S � ����� <br /> (roztitaci pcice} (minimnm Si0.00) <br /> 2. ST ATE SURCH.A.RGE � �� <br /> .�1�j�c�c'� � .aoo5 � -� ._ <br /> �����t�,�;��> <br /> 3. POSTr�GE&HAAIDLING (Only oa Mail In:4ppiicatians) � ' <br /> �:�c� <br /> 4. TOTAL PER�I�IIT FEE (.Add Lines 1-3 Above) S ��� �� <br /> * CO�:TRACT PRICE or JOB COST meaus the actual or estiulated dollar �ount charLed for the <br /> pennitteci���ori� including materials,labor,prafif,and oiher fiaed costs. It is the amauni to be chareed <br /> to th�e customer for the �vork done. If any material, equipn�ent, labor or insiallations are furnished by <br /> the o«ner, teuanf or any other party, the reasanable market value of such items must be added to the <br /> estiniated cost or contract price for permii fee purposes. In t�ie event that there is a dispute on the <br /> anlount of tlie j�b cost, the City may requzst the submission of a signed copy of the aclual contract. <br /> � PL:I�I�IB�TG PFIZI�IIT .�1PPIJICg�TI(�I�AGF�E��ENT <br /> T�e undersigued her�by ap�lies to the City for issuance of a Phimbin� Pern�it, agrees to do all <br /> work ui s�rict accordancz �vith the ordinanees of the City and the re�ulations of thz State of <br /> l�iitlnesota, and cerEifies that all statements made an this applicarian are complete; true and <br /> correct. <br /> .--'',J� � ,��� � .. f '� <br /> flpplieant's Signattzre: � t � �-� �� Date: � � � <br /> s� <br /> 3 <br />