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06/14/2016 08:57 FAX 95293a5049 CULLIGAN MriTKA f�004 <br /> . <br /> , <br /> ��S' 'y�ll,�.l '�M! �1 �' � � '1�'p'; M �1 II�1�^J'I� ���)Y� <br /> �w����:,��'��r.'''•.i,���i!;.���;����lt'�.'�����;�;?���:,.:;,b'„��,Q�';5�,,„�4�'�;,,�`�R;,R',$��Ob:!0,'�;�;.j,"r`s'��';�,�;;��,';,.�!:��;;:.c'�; <br /> 1f abovc docs not�pply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1,25%of contract price with a(Minimu�m�'ee of$50.00) <br /> x_0125 S <br /> (wntrdct priCe) (minimum SSD.00) <br /> 2. STATE SURCI�ARCE **Add thc Statt$ldg Code Div.Surcharge(Minimum Fee of 55.00) <br /> GTG�� �� <br /> ./ x.0005 $ <br /> (wntt8tt prlce) (minimum$ 5.00) <br /> 3. PQSTAGE&HANr1�L1NG(Qnly on Msil-In Applications) $ 2.00 <br /> 4. TOTAI.PERMIT F'��(Add Lines 1-3 Abave) $ .�o� . c�7 <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimatcd dollsr amount charged for the <br /> permittod work including materials, labor,profit,and other fixed r.osts. It is the amount to bc charged <br /> to the customer for the work done. If any macerial,equipment, labor or installations arc ivmished by <br /> the owner,tenant or any other party,thc ressonable market value of such itcros must be added to the <br /> estimated cost or contract price for perntit fee purposes. In the event that there is a dispute on the <br /> aznount of thc job cost,thc City may reqtlest the submission of a signcd Copy of the actua! contrac�. <br /> ■ *"The STATE SURC7�TARG�is.0005 of the contrsct priee under$1,044,000 or$5.00—whichcver is <br /> greater. For valuations o�er�J,OOQ,Q00 call the Building Deparlment at(9S2)249-4600 for the price. <br /> 't:! w ��(5�/� � i�- - F7� r�!�r,, �p ���. ?�y��,y 'y�r", y�� ;y •Lrr'r„ iv�"f i <br /> �L��,nGhp�'��;�{�!�l,G4 J7��;Yah�7?��,'�i�r '� ��'��D��'F;'���,�T:�'..`"sV�'1'S,�d'1 '�°'.?'c'N+j�;�',�'"�. f^�;Lx?�2°,rp�';j��h1 I��� <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do a11 <br /> work in sfict accordance with th� ordinances of tY►e City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this applieation are complete, tru� and <br /> correct. <br /> Applicant's Signature: � Date: ' �.� ' <br /> ;"��'i'I'"•''�'������i(��r�'GP� <br /> �P l�'!u .� <br /> ,y.�I��.�•h�r��N� <br /> 3 <br />