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11/0�/2015 11:28 FAX 9529�35049 CULLIGAN MNTKA 1�00i
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<br /> � I�abo�ve does not appiy;follow guidelines below: , �
<br /> ]- CONTRAC�'X'RTC� * is 1.25%of contract price with a(1Vlinimum Fce of$50.a0)
<br /> x.012�$
<br /> (can�act pfiCe) (minimum$50.00)
<br /> 2. STA�'�SCIItC�TARGE '�*Add rhe State Bldg Code Drv.Surcharge(Mfiaim�m Fee or�5.00)
<br /> x.000� $
<br /> (con�rac�pricc) (minimu;r,� 5.00)
<br /> 3. POSTAGE&HANDLING(Only on Mai1-]n Applications) $ 2.00
<br /> 4. TO'C'AL.PERMIT FEE(Add Lines 1-3 Above) � ��,��
<br /> ■ * CONTRACT PRIC� or JOB COST means the actual or estimated dollar amount char�ed for the
<br /> permi�ted work including matcrials, labor,profit,and other fixed costs. It is the amount to be charged
<br /> to the eustomer for the work done, Cf any material, equipment, labor or installations are fumished by
<br /> the owner,tenant or any other party, thc rc�SonElble market value of such items must be added to the
<br /> estimated cosY or contract price for permit fee purposes. In She event that therc is a dispute on the
<br /> an�ount of the job cost the City may reques�the submission of a signed copy of the actual contract.
<br /> ■ **The STATE SURCHARG�is.0005 of the Contract price undcr�1,000,000 or$5.00--��hichever is
<br /> greater_ For valuations over$1,000,000 eFi11 the�uilding Dcpartment at(952)249-4600 foC ihe pzice_
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<br /> 'I't�e undersigned hereby appIies to the City for issuance of a Plumbing Permit, agrees to do aIl
<br /> work in strict accordance with the ordinances of the City and the regulations of the State of
<br /> Minnesota, and certifies that aIl statements made on this application are complete, true and
<br /> correct.
<br /> A licant's Signature: � Date: � �� b- �
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