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11/07/2012 03:23 IFAx 7634775629 f�004/004 <br />.. , � <br /> � , . <br /> ; <br /> ,,�,r, ���' <br /> � .N <br /> �'�IY�.�:�I��k:'�Ni �, � <br /> '����i�i�� '�':�•'y> � <br /> :;e. n;�� I <br /> lf above does not apply:follow guideline�balow: � <br /> �i l. GnN'�'RAC'T PRtCE "' is 1.25%of contracL price with a(Mlnimum Fcc of 550.00)i <br /> � � x.0125$� ' — <br /> � (ppntractP��) (minimum S5U.q0 <br /> � � <br /> � 2. s•rAT�suKc � ' , X.000s $_,�—�—� <br /> _L�—.-- <br /> �������� <br /> I on Mail-In A licr�tions) $ 2.OQ � <br /> � 3. PUSTAGF&HANllLiNG(Only PP ; <br /> ' � <br /> I� 4. TO'fAL YERMiT Fk�E(Add Lines 1-3 Above) � � <br /> ,� � • �;ONTRAC�'1+ PR1C� or 70B COST mcar►s the actual or estimated dollar amount char�ed r the __ <br /> • pennitted work including materials•�abor,proft,and othcr fixcd costs. it is the ecn�unt to bP�, arged <br /> tc�thc customer for the wock done. lf any materia�,equipmaft, labor or installacions are fur�is ed bY <br /> th�owncr,tenant or tu+y other party,thc ceasonablo marlcet value of such itGms must bo ad�c to the <br /> es4imat.�d cost or contract price f�r p��mit fee purposcs. in Ute event thet thcre is s dispulce on the <br /> a�ount of the job cost, the City mtiy reque�t the subr[lission �f a signcd copy of the actuaL niract, <br /> ' � <br /> � <br /> i (� I , ` <br /> , ��, h..N <br /> -�igt.,,.. ..� <br /> .P':r�'�v�•:iµ •'" u <br /> � <br /> Thc u�d�.h'signed herebY aPP��es to che City for issuance of a Plumbing Permit, agrecs;to do aU <br /> w��rk �in strict aecord�r►ce wi�h the ordinances pf the City and the regulations of th� S te of <br /> I Minn�snla, ancl certities that all state made on this spplication are complete,� e and <br /> , cc�rreat. � <br /> � <br /> I' I Date• ��' �� <br /> Appli�ant's Signaturc: . — � " ' <br /> .r:f i�:���,�I'i.�';!�Yui:f.��:};'�.�,+K�hiB d1{:)• �.�, In. . <br /> , .; � : <br /> i.� r..;�r•:;:. ' . ..'. <br /> �{ :.. <br /> �r,,,•;-,;.i•..r .: <br /> �••�,,,•...,. ..w . <br /> �. .u....�.. ,., ,1 <br /> �'�`I:"'•%:i'�f:.�i1-?!S)�''r:�J�;Y17:".�r:n.i,IL�I;? •.e�... <br /> I � <br /> II I <br /> � 3 . <br />