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12n1212012 03: 12 FAx 76347756�9 I�004/004
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<br /> i lf above docs not apply;follow guidelines below:
<br /> I �` + CONTRAGT PR10E '� is 1.25%of oonhact price with a(Mlnimum Fee oT SSO.OU)
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<br /> , � + x.0125$���, �
<br /> (con�n�cc pricel (mlfiimum 550.00)
<br /> 2. STATE SURCHACiGE
<br /> �r .__x.0005 $ /+� �
<br /> � � I (coMraa pricc) .
<br /> ' �. tyOS7'AGF.&T[ANDLING(Only an Mail-Jn Applications) $ 2 0
<br /> 4. TO'l'AL I'ERMlT FLE(Add Lines 1-3 Abov�) $ � /
<br /> I ■ * CQNTRACT PRICE or 10H COST mesns thc actual or,estimated doilar amounl charged fo the
<br /> per,;itted wprk incit�ding materiuls, labor,pcofi�and othe�fixed eosls. It is tha amount to be cha ged .�,,,,�� :,,„,
<br /> ���� "-'���' ��' � to`th�cusmmcr t�or the work done. If any mAterial, �quipmcnt, labor or installations are furnish by _ .
<br /> thc dwncr,tenant or any other party,the reasonable matkel value of sueh items must be addcd the
<br /> tslimatcd cost or contract price for perrnit fee purposes. !n the ewent that there is a dispute o tha
<br /> , amount of the job cost, �he City may rcqucst the submission of a signcd copy of the actual con ct.
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<br /> The und�ersigned hereby applies to the-!City for issusnce of a Plumbing Permit,,.ag}�ees to d al1
<br /> wark in strict accordance with the ordinances of the City and the regulations�of'the.Stax . Qf.
<br /> ' Minnesdta. and certifies that all statemen[s made on this application are comp'IeCe; 'truc and
<br />� correct. - •]:.;� ._;
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<br /> Applicant's Sig�a�ure. Date:� — �'
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