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03/27/2a12 12:00 FAX 9529335049 CULLIGAN MNTKA �007 <br /> � <br /> ' �a2,�,•�r4Y��„'1—��':';�i{J�:li::l. . 4. :�. .�. ,��.� ,. .�3: �' r�l$''�''7ii,"•�':�r�'r-rt:1 <br /> � �' ��.���'�'... �.;..., � d-a'�:'�.=. <br /> .��:r,:: r:�:�E��.,..�•�:.�:,"�� -�;:�.I�'.� :w;�� '��; T1����. t ;00�:;� -�,.s�;....�.,a.:,:, <br /> If above does not apply;follow gnidelines below: <br /> l. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of 550.00) <br /> ' x.0125 $ <br /> (contractprice) _ (minimum�50.00) <br /> , y <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of 55,00) � <br /> � x .0005 � <br /> (contract price) (minimum S 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> � 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S �, o� ��v <br /> � ■ * CONTRACT PRICE or 10B COST means the actual or astimated dollar amount charged for the <br /> � percnitted 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 pertnit fee purposes. In the event that there is a dispute on the <br /> , amount of the job cost, the City may requast 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 /> Igreater. For valuations over$1,000,000 call the Building Departrnent at(952)249-4600 for the price. <br /> ��� a t � ;��i ��`�w;;�'�� -� A`"�G p`� ' ;:��?'�r,��'t�`�`.[Q����`xR�L,` '�', � ; <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 5tate of <br /> � <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> A licant's Si nature: � Date: `a - � <br /> PP g -3 � <br /> � �� � . <br /> ,; , <br /> ,Q,�.��;� <br /> ,, .#��a�.-��� <br /> 1 <br /> . n <br /> 3 <br />