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03/27/2012 11:59 FAX 9529335049 CULLIGAN MNTKA C�004 <br /> . <br /> .ii�::�d�ta"?��:t��-�rZ�' .t;r. ..y. �ti�-�. .�I��rbx.� ,4.: . i'L9n:HP.kv �i.�'�0�.i';�� <br /> :i^;. .#, �t;•_C .1.1L: "tl ';�.';`�l�� "o' ���-�:i-. �i.. �.i'�y.'[1 I !i!�ii_f:.�rtft `,�{�`;,µ�f.�i <br /> .,�;:i4'�k�:,.4;�.k. i..;�y�,r,,�, ..��' iJ� ".`SkL!_ ,�,��';�� '-"'!.`��D;i7`.' �i,' _:c�r.rR .i.�' :.�r:�?�:. <br /> �r� ,� '�.�� ,t r�v;u!. <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 /> (conaact prica) (minimum$50,00) <br /> 2. STATE S�(JRCHARGE *'"Add the State Bldg Code Div.Surcharge(Minimurn Fee of SS.00) <br /> x.0005 $ <br /> (conttac�price) (minimum T 5 00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) 5 ��. 0 V <br /> ■ * CONTRACT PRICE 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. If 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 SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. For valuations over$1,000,000 ca11 the Building Department at(952)249-4600 for the price. <br /> , � .� „ P <br /> �^.r 1 s �M � :'i E i. `�'+,1 i 5 u�' � ��� �7 .�1}.f,L�.lfj"�. <br /> 1 �.�1�t �,e.h � 1 4 j,� ' <br /> The undersigned hereby applies to the City for issuance of a Alumbing Permit� agrees to do all <br /> - work in strict accvrdance 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 /> ' . � Date: 3`c�-7- j � . <br /> Appl�cant s Signature� <br /> s, �-'� �a <br /> `�,P'S @�.�'��'I'�1, <br /> 3 <br />