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� <br /> a <br /> ` PL�1U�81�"� FIX ;�.-�� B"EIl�G IAlSTAI.LED ' � ;; � . ., ,:�... � .; �. <br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sr 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet � Floor Drains � <br /> Lavatory 7 Sewer Ejector <br /> Bathtub � � Laundry Tray f � <br /> Shower ` � Washer <br /> Kitchen Sink � Water Heater � <br /> Disposal � Water Softener � <br /> Dishwasher Wet Bar / <br /> Sillcocks � Miscellaneous � <br /> ° F�RMtT FEE CALCULAT[ON ;"�'� <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> _�'%.� L�1'-�'.`,L�"� x .0125 $ ��S 7,�� <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> � �5���:���' x .0005 $ �7.��� <br /> ( ontract price) <br /> 3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ � /��,���� <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to <br /> the customer for the work done. If any material; eauipment, labor or installations are furni�he�+ �y the <br /> owner, tenant or any other party, the reasonable market 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 /> PLI:�l�{���I�:#��RM�T APPL.ICA1"�4N AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in <br /> strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and <br /> certifies that all statements made on this application are complete, true and correct. <br /> ApplicanYs Signature: Date: <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />