Laserfiche WebLink
12/14/2016 09:04 FA% 9529335049 CULLIGAN MIVTKA �005 <br /> ;L�'��ra��,�:� � . :����'�����,��1�����;�'E���R��, �,�:G��T�'�;"'CE�3:;�������`�;:���-���"���,�.�„�„�;�;�, <br /> . "� dxM�i' �7� � � ar m w�r+n.��roi <br /> � <br /> FUCTUR� BSMT 1�T 2ND OTHER FIX7URE BSMT 1ST 2"D OTHER <br /> IYP� Floor �loor 7YP� Floor �loor <br /> Water Closet Floor Drains <br /> l.avatary Sewer�jector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Neater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> ` �r' IA I!A ul 1� JV r� tiY�!•7i1MN����� i �f�/�•iMlili.M. I W'�`, � n. � <br /> 1. CONTRACT PRICE *is 1.25% of contract price with a (AAinimum Fee of$50.00) <br /> �O4 � x _0125 $ <br /> (contract price) (minimum$5Q.00) <br /> , 2_ STATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3_ POSTAGE�HANDLING (Onty on Mail-In Applications) $ 2.00 <br /> a. TOTAL PERMIT FEE (Add �.ines 1-3 Above) $ .��, � <br /> "' CONTRACT PRICE or JOB COST means the actual or estimated dollar amourrt charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount fio be charged to <br /> the custom�r for the work done. If any mat�rial, equipmerrt, labor or installations are fumished by the <br /> owner, tenant or arry other party, the reasanable market value of such iterns must be added ta tha <br /> estim�ted cost or contract price for permit fee purposes. ln.the event that there is a dispute on the <br /> amount of the job cost, the City m�y request the submission of a signed copy of the actual corrtract. <br /> Rrp!!� r 1 ��`y/y,�,N I��/���y� �IN y !� II <br /> IA PQ � 1 I . '+'N-`.0 �M M� i.i�7r tl � Y1r iY� � i ,NN <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 sfatements made on this application are complete, true and correct. <br /> Appficant's Signature: Date: ��'�- �b <br /> Building O�icial/Inspector: pate: <br /> Page 2 <br />