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09/05/2012 13:21 FA% 9529335049 CULLIGAN �NTRA �004 <br /> ...� . .� - '{ t '/� . ���i;�;..• .�'T�r <br /> T,:r*, a: ,c �C� `!iY•� .t^.�f;'�Y: :h�"•�:o,'r.r <br /> Y 4 r• <br /> If ebove does not apply;follow guidelincs below: <br /> 1. CONTRACT�'RICE *is 1.25%of conttact price with a(Miaimnm Fce ot S50.00) <br /> x.0125� <br /> (contract pncc) (minimum SSo_oo) <br /> 2. STATE 3URCHARGE *�Add tfie State Bldg Code Div.Surchatge(Minimum Fee of SS.00) <br /> x.0005 $ <br /> (conuact price) (minimum S 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-in Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S ��0� <br /> ,,�. ��... ;„� . . _ . _ .. _ _ <br /> ■ " CONCRAGT PR10E or JOB COST means the actual or estimated doUac am�unt charged for the <br /> permitted work including materials�labor,profit,and othet fixed costs. it is the amount to be charged <br /> to thc customer for the work done. If any material,equipment, labor or instellations are i�umished by <br /> the owner,tenant or arry other pariy,the rea4onable market velue of sach items must be added to tha <br /> . estimated cost or contract price for permit fee purposes. In the event that thera is a dispube on the <br /> amount of the job cost,the City may request tfie submission of a signe� copy of tho actual contract. <br /> ■ "`*The STATE SURCHARGE is.0005 of the cflntract price under�1,000,000 or$5.00—whichever is <br /> greater. For valuations over S 1,000,000 call the Building Department at(952)249-4600 for the price. <br /> The undersigned hereby applies to the City for issuance of a Ptumbing Permit, agrees to do all <br /> work in strict aceordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statemants made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: Date: Q—5 • � � <br /> 3 . <br />