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06/11/2013 11:45 FAX 9529335049 CULLIGAN MNTKA �j004 <br /> '::1'ERII�I,IT��E'CAZC�A�'I�N�' '=,JOBS C)�ER.$SOQ:UO <br /> If above does not a�ply;follow guidefines below: <br /> 1. CONTRACT PRICE �` is 1.25%of contract price with a(Minimum Fee of$50.00} <br /> x.0125$ <br /> (conh'act price) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(M;nimum Fee of�5.00) <br /> x.0005 $ <br /> (contract price) (minimum$ 5,00)T <br /> 3. POSTAGB&HANDLING(Only on Mai1-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ aa•U� <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materiais, labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, cquipment, labor or installations are fumished by <br /> the owner,tenant or any other party,the reasonable market value of such items must be addad to the <br /> estimated cost or contract price for permit fee purposes. In the even#that there is a dispute on the <br /> amount of tha job cost, the City may request the submission of a signed copy of the actual contract. <br /> ■ ** The STATE SURCHARCrE is.0005 of the co�tract prica under$1,Q00,00�or$5.00—whichever is <br /> greater. For vafuations over$1,000,00�call the Suildine Department at(952)249-4600 for the price. <br /> 1��`����i�,.,,Y'� . .":_."�'�,UMBII�G PERM�!'�I'i�LrCA'f10N;AG°R�GEMENT. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do al1 <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all staternents made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: � �ate: � - 1U-� <br /> � a���;�a;m ���;,,;�r;a <br /> ��:�5��°�p[{C•11� <br /> -7�F?t����,�'s,�,v�:�,:t�u�+,. <br /> 3 <br />