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07/08/2013 ll:53 FAX 9529335049 CULLIGAN MNTKA f�004 <br /> =.. ;� . .T{�PE����:e�cur�T�o�v.s. �����as.o�:�sao:oo . . ,�;� . . _ , <br /> If above does not apply;follow guidelines below: <br /> 1, CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of�50.00) <br /> x.0125$ <br /> (contract pnce) (minimum$50,00) <br /> 2, STATE SURCHARGE **Add the State Bidg Code Div.Surcharge(Minimum Fee of�5.00) <br /> x.0005 $ <br /> (contract price) (minimum$ 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications} $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �a•�� <br /> + * CONT}tACT PRICE or 70B COST means tha 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. If any material, equipment, labor or installations are furnished 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 SURCHARGE 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� ?�ki'.�`+,' '� ��f��� 1' .�r �yi�:7i�+�i �7 �p d,�/�nr� t i 3�4pI�I �'�.fil�lt�,±ktF:im:;i <br /> �'4i,�i+'�i.�"lsf'".`�iA�o��.F.it,�(..1.EU:1�/'�� ^�{,P���1��� I",4-�:[,3`=�A'i;;l�l�l tl'U1�:1���1�, r,�; �.t,�;'{���+rt.. ,{ <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 all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: �� Date: ! ' � " r 3 <br /> ,���e�„��i1�t���' �F <br /> �.��:;T�,,.,,t,��,�.'�;`: <br /> 3 <br />