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01/02/` 013 13:50 FAX 9529335049 CULLIGAN MNTKA [�]004
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<br /> If bove does not apply;follow guidelines below:
<br /> 1. CONTRACT PItICE * is 1.25°/a of contract price with a(Minimum Fee of 550.00)
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<br /> . x.0125$
<br /> (contract price) (minimum$50.00)
<br /> 2, STATE SURCHARGE **Add the State Bidg Code Div. Surcharge(Minimum Fee oi$5.00)
<br /> x .0005 $
<br /> (contract price) (minimum$ 5.00)
<br /> 3. P05TA�&HANDLING(Only on Mail-in Applications) $ 2.00
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<br /> 4. TOTAL ERMTT FEE(Add Lines 1-3 Above) $ o�o�� OQ
<br /> ' �'��� � � 'R � �j1 * CONTR,�CT' R10E or !OB COST means the actual or estimated dollar amount charged for the ���`�"'�
<br /> permitted work i cluding materials,labor,profit, and other fixed costs, lt is the amount to be charged
<br /> to the customer for the work done. [f any material, equipment, labor or installations are fumished 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 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$1,000,000 or$5.00—whichever is
<br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
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<br /> T�►e undersigned herehy applies to the City for issuance of a Alumbing Permit, agrees to do all
<br /> work iq strict accordance with the ordinances of the City and the regulations of the State of
<br /> Minnesota, and certifies that all statements mada on this application are complete, true and
<br /> correct.
<br /> Applicant's Signature: Date: �-07 ' �3
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