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CITY OF ORONO � b124730510 09/15/9� 13:48 � :03/03 N0:380 <br /> � <br /> ������ <br /> I. 1.2�% of Con r�•t Yri��* or ��n�mam Fee t�3S.0i)) <br /> � ��' <br /> _ _ x .0125 $ � � <br /> (contract price) <br /> �. St��� ,�ur�harse. *�' A�id the Stxte Build'zng Cacie Division <br /> Surclzarge to �ach percnit. X ,ppp� � `j o <br /> (conlruct price) � <br /> c�r $.50, whichever is greater <br /> 3, �'oata�e an �n�lins (Qnly mail-in applicatians) $ p <br /> 4. TOTAL, PERM�T FEE (Add lines 1-3 above) $ � �� p � <br /> * CONTRACT P1�10E or JOB COST me.ws the actuai or estittutted dcrlls�r amuunt charged for[h�psrmittcd <br /> work ineluding nia�crial�, labor, profit, ancl other fiaed costs. Ic is clia urr�unt ta hc chargetl to the <br /> customer for thc work done. If auy material, equipment, labor,or instaFlntion are furnisl�ed by atc awner. <br /> tc�a»t or an� anc�r parry tl�c reasonable rn:�rket value of such ite�nv mus� be addcd to thG egtimatecf cost <br /> or. car,trac� �?r±ce fnr�er:n:! fee pur�,ose,s. �n chc:eyenl th:�t there is a disgute on the s�nount of thc job cUst, <br /> tJ1c City rr�ay requc�t the suhniissio�� of a signed copy oi'ehe actual wntract. <br /> *"' The STAT� 5LIRCHARGE is .O�OS c�f the ceantract price vnder $1,UOO,Q� or $.SO - whichever is <br /> };reater, Far vaZuativns over $l.OQ0,0()0 cnll the Depart:nent of)nspectional Scrviccs for the price. <br /> T'h� undersigned hereby applies io ch� City for issuance of a plui�ibiilg Pcrmit, agrees to do all <br /> work in strict accord:�nc:e with th� ordinances of the City and th� regulations of th+e Stat� of <br /> Miruiesota, and certifies ll�at .iEl staterneitts rnade on lhis applicttlion are complctu, true an�3 <br /> correc:t, <br /> � <br /> % � ' � <br /> if <br /> Applicant's Signature: � �L- Date: - �,: � <br /> � . <br /> 03/23/I5 04 :93 'l'X/RX N0. 1267 P.003 � <br />