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, . � <br /> 04/09/2013 13:29 FAX 9529335049 CULLIGAN MNTKA f�j004 <br /> ' ;:k. � ::'��R1vITT,FE�;�A�CUL'��'Tfi�N �`'`=�:T�?$�O�R.$�00:00 <br /> If above does not apply;follow guidelines below; <br /> 1. COl\'TRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> x.0125� <br /> (cont�act price) (mmimum$56,00) <br /> 2. STATE SUl2CFTARGE **Add the State Sldg Code Div. Surcharge(Minimum Fee of$5.00) <br /> x.0005 $ <br /> (contractprice) (minimum$ 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $_ z.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 <br /> [o 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 market value of such items must be added to the <br /> estimated cost or co�tract 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.QOQS of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. For valuations over$1,000,000 call the Building Dcpartment at(952)249-4600 for the price. <br /> ���i.�t..,�,�: 1 ,u ;..4� n��...`�� " i iL9" . .�Jz`. `;'� .r. ,�. �"�.��tta��.'�._���.• ��• .� . <br /> i <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 a1! statements made on this application are complete, hue and <br /> correct, <br /> Applicant's Signature: � Date: � ' I - �� <br /> �� E_i��°;<����, <br /> 3 <br />