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11/06/2015 11:28 FAX fl529335049 CULLIGAN hiNTKA f�004
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<br /> .�. � x -,,���w FEE';C ��;GY�'L`r�A`;T:TO'N S',�a:��7�5;(�'�ER'$5'q(� 00+' ' ' '"�
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<br /> If above does r�at apply;follow guidelines below: + -
<br /> 1. CONTRACT PRXC� �`is 1.25%of contracC price with a(Minimum Fee of�50.00)
<br /> x.0125 $
<br /> (conQact price) (minimum$SO,DO)
<br /> 2. STATE SURCTi�AitGE **Add the Statc Bldg Code Div. Surcharge(Minimum Fcc of 55.00)
<br /> x.ODOS �
<br /> (con[rac�price) (minimum S s.00)
<br /> 3- POSTAGE&HANDLP.vG(Only on Mail-in Appliaations) $ 2.00
<br /> 4. TOTAL P�}�MIT F'EE(Add Lines 1-3 Above) $ ��• U v
<br /> ■ "` CONTRACT PRICE or JO� COST means the actual or estimated dollar Amount charged for the
<br /> permitted work including materials, Iabor, profit,and other fixed costs. It is the amount to be char�ed
<br /> to r.he customcr for the wark donc. if any material, equipment, labor o�installations are furnished by
<br /> the owncr,tenant or any other party, the reasonable market value of Such items must be added to rhe
<br /> � estimated cost or contract price for permiC fee purposes. In ihe event that there is a disputc on the
<br /> amount of the job Cost,the City may request the submission of a signcd eopy af the actual Gontract.
<br /> ■ �*Thc STATE SL'RCHARGE is .0005 of the eontract price under�1,000,OD0 or$5.00—whichever is
<br /> greater. For valuations over�1,�00,000 cs11 the Suilding Department at(952)249-4640 for thc price.
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<br /> The undersigned hercby applies to the City for issuance of a Plumbing permit, agrees to do all
<br /> work in strict accordance with the ordinances of the C�ty and the re�ulations of the State of
<br /> Minnesota, and certifies that a]! statements made on this applieation are complete, true and
<br /> correct.
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<br /> AppIicant's Signat�re: UC Dat�: l� �� �
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