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03/28/2011 13:10 FAX 9529335049 � CULLIGAN MNTKA C�004 <br /> _ • � <br /> . I <br /> i �k.�y..., x"'a:�i:t'� 7x � rt =� i- �'/. d .L ' ,V r ��� �u;�fib;9�• .fR,U;ii',v :i <br /> , :• <br /> .. . ..,.�� � � � <br /> . ,^. . �� <br /> ,`�'�i,�,b';;K�¢.�'T���P'F?:;"��:•G+`2` , ''� .!� tl 't��y,� '�i' �.��.' •''`," �v+�n,a:Y� �.n <br /> ,.. �v� ....,.,,.. .'.;._;`�` ` ° � ,..,.�.��f i �'.,'h.,.'-. �i.`rr;G;.Yn�L;:.... ��i� <br /> if above does not apply;follow guidelines below: <br /> ; 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee oF$50.00) <br /> x.0125 $ <br /> (contract price) (minimum$50.00) <br /> 2. ST�TE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee oiS5.00) <br /> x .0005 $ <br /> (contract price) (minimum� S.OD) <br /> 3. POSTAG�&HANDLING(Only on Mail-ln Applications) $ 2.00 <br /> 4. TOTAL P�RMIT FEE(Add Lines 1-3 Above) $ �o� . �� <br /> ■ * CONTRACT P�ICE or JOB COST means the actual or estimated doflar amount charged for the <br /> I permitted work iqcluding materials, labor,profit, and other fixed costs. it is the amount to be charged <br /> ' to the customer r the work done. lf any material, equipment, labor or installations are furnished by <br /> the owner,tenan or any other party,the reasonable market value of such items must be added to the <br /> estimated cost o contract price for permit fee purposes. ln the event that there is a dispute on the <br /> � amount of the jo cost, tl�e City may request the submission of a signed copy of the actual contract. <br /> � <br /> ■ **The STATE CHA�tGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. For valuations ov�r$I,000,000 ca11 the Suilding Department at(952)249-4600 for the price. <br /> � <br /> r- t' , �' � ' ,1�. j� <br /> � <br /> � I The u dersigned hereby ap lies to the City for issuance of a Plumbing Permit, agrees to do all <br /> work ' strict acco ance ith the ordinances of tha City and the regulations of the State of <br /> Minne�ota, and ce fies t t all statements made on this application are complete, true and <br /> correct. <br /> ! Applicant's Signa Date: 3 —c�� — � � <br /> � r <br /> , ,�, �.:- � <br /> Rese�F'a%m�, <br /> I , <br /> I <br /> t <br /> ( <br /> 3 <br /> r <br />