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06/19'�2013 21 :43 FAX 7634775629 �j004/007 <br /> . • . � <br /> ti . <br /> If above do�not appiq;follow guidelines below. <br /> 1. CONTRACT P Y *is 1.25°0 of contract price with a(Minimnm Fee of S .00) <br /> � �/ x,0125� <br /> (�a�cepaice) (minim sso.90) <br /> 2. S�'A;C�SiTRCHARGE � <br /> . _.......,.x.OQOS $._� <br /> l��t�) <br /> 3. POSTAGE�t HANDLING(Only on Mai�-In Applicatiqns) $ 2. <br /> 4. 7'OTAL FERM[T FEE(Add Lin� 1-3 AbovC) S ` <br /> ■ * CONTRACT PitICE or JOB COST means th� actua! ot estimated dolla�r amount cha for the <br /> permitted work including mate�ials,labor,profit,and o�ar�ced costs. it is the amount to e chacged <br /> tn thc custoaner for t�e work don� if any material, equipmenr,labor or installations arc f ' hed by <br /> the owne�,temant or any other party,the reasanable market value of such ite�s muat be ad ed to the <br /> estimated cost or comract prics for pe�rtnit fee purposes. In the eve�rt t#�at the�e es a dis e on the <br /> amount of the job cnst, the City may request t�e submission of a signed copy of the actual contract <br /> T�e undersigne�i hereby applies to the City for issuance of a Plumbing Permit, agrees to do all <br /> wdrk in strict accordance with the ordinances �f tbe Ci.ty and the rcgulations of the S o of <br /> M�nnesota, and certifies th�t sil statements made on this applicstion are complete, and <br /> co�rect. <br /> � /,,f �y� <br /> Appliaa�t's Signature: _�...� Date: (Y � � <br /> 3 <br />