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Feb. 2. 201� 1 : 29PM No, 0359 P, 4 <br /> l'ERiV1IT.FEE CALGL7�A�ION S)—JO$S 0'V'E�'$SOO:QO J' <br /> W ' Y.a <br /> ' If above does not apply;follorv guidelines beloru: <br /> �. CONT�tACT PRYC� '"is 1.25%of contracC peice�vith�(Minimum Fee of$50.00) <br /> c,0 u•=� <br /> 3, �x�,C7'� x.01z5$ '�G <br /> canlmct price) (minlmum 550.00) <br /> 2. STATE SCJRCHARGE ,,.,, <br /> 3 ��oc�^ x.000s $ � .�o <br /> contrac�prica) <br /> 3. pOSTAGE&HANDLING(Only on M�il-In Applic�tions) $ 2.00 <br /> 0 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � 3 — <br /> ■ � CONT7tACT PRTCE or JOB COST,ncans th� actual or estimated dollar am nt cl� for the <br /> pannitted�vork including m�terials,laUor,profit,�nd otl�er fixed cosCs. lt is thc amount to be charged <br /> to the customer for tiie work done. Tf�n�material, equipmcnt, IaUor ar installations are furnished by <br /> the o��rner, tenant or�ny other p�rty, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. Tn the evci�t tl�at there is a dispute on the <br /> �motmt of the job cost, tf�e Ciry may request the s��bmission of a signed copy of the actual confract. <br /> ,.�.; � _ P�;YJMBTI�TC�P�I2IVIIT,ApP1..ICATION AGRRRMFNT���;,. ;: `: ; <br /> The undersigned hereby applies to the City for iss�tance oF a plumbing Permit, agrees to do all <br /> �vork in strice accordariee with the ordinances of the City and the regulations of the 5tate of <br /> Mmnesota, and certifies that all statements made on this appliCaCion are complete, true and <br /> correct. <br /> .....� <br /> Applicant's Signature: Date: �l�-��5� <br /> 3 <br />