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`. . <br /> 4 h+ ? b#.F �.4.A�' - <br /> 1 ,}"}k.Rd��,_� �.i1'zF.l z 1 +k.,` i. <br /> ry ��'' Y <br /> FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet a- �-- Floor Drains � j <br /> Lavatory a— � � Sewer Ejector <br /> Bathtub Laundry Tray � <br /> Shower � � Washer � <br /> Kitchen Sink � Water Heater � <br /> Disposal ' Water Softener ( <br /> Dishwasher � Wet Bar � <br /> Sillcocks Miscellaneous <br /> � �� ��,�, y r,� : � <br /> a ' :��,fi ``��:� � �, `�#s '.`s� "'�t�..� .:c�..`�`.�" "� �� rs . <br /> 1. CONTRACT PRICE "is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> a e . � 3s-� -- � � <br /> x .0125 $ �� ..�'I <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> �� lv �5��� X .000s $ � � - 3a <br /> (contract price) <br /> 3. POSTAGE � HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ � � �� � � <br /> '` CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to <br /> the customer for the work done. If any material, equipment, labor or installations are furnished by the <br /> owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> .� � G� : s5�,,� r . ,,. . . . . �, . <br /> ,o-��"� s �4-;�3t��'�"��-''�,.�' �� '��s'`� ,fi '�. ; , i � : ;��.. ,' , �.. ?� .. *� ��Rs ,,,;��� ��r�.„v„e.���4,P3 �.�"�'?�';��� y���i`�<;�� <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 statements ade on this application are complete, true and correct. <br /> Applicant's Signature: �- ��� Date: ��� ��� <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />