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12/13/2011 13:55 FAX 9529335049 CULLIGAN MNTKA f�004
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<br /> If above does not apply;follow guidelines below:
<br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of 550.00)
<br /> • x.0125$ �
<br /> (contrect price) (minimum 550,00)
<br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. 5urcharge(Minimum Fee ofSS.00)
<br /> x.0005 $
<br /> (contrac[pnce) (minimum S 5.00)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
<br /> 4. TUTAL PERMIT FEE(Add Lines 1-3 Above) S �.o�•��
<br /> ■ + CON'1'R.ACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
<br /> permitted work includi�g materials, labor,profit,and other fixed costs. It is the amount to be charged
<br /> to the customer for the work done, If any material, equipment, labor or installations are furnished by
<br /> the owner,tenant or any other party,the reasonable mazket value of such items must be added to the
<br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
<br /> amount of the job cost,the City may request the submission of a signed copy of the actual contract.
<br /> � **The STATE SURCHARGE is .0005 of the contract price under$],000,000 or$5.00—whichever is
<br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for tha price.
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<br /> The undersigned hereby applies to the CiTy for issuance of a Plumbing Permit, agrees to do all
<br /> work in strict accordance with the ordinances of the City and the regulations of the State of
<br /> Minnesota, and certifies that a11 statements made on this appfication are complete, true and
<br /> correct.
<br /> Applicant's Signature: Date: I a' �3 ' � � �
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<br /> "F�`eset,�ornri' �
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