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j ` 11�16/2013 08:00 9528947972 LAKESIDE PLUMBING PAGE 02/04 <br /> ��;����` .,�����`�'' �'�P'ERIVI�IT;FEE��CAT�CU�ATI�OI�{����'�-TCtI�Si����R�S'�0�0�'.0p ��� � ,� <br /> if�bovc docs not apply;!'ollow guidclines I�elow; <br /> I. CONTRA,C'�'.�'RIC� "' is 1.25"/0 of contract price witl�fl(Nwireimam fcc of�5n.flp) <br /> 27�.1'� x.0125 $ <br /> ----.,.. .. .._ <br /> (conU'�Cl priccl (rltinimum S$0.001 <br /> 2. STA,T�_SUT�Ci�IARGC <br /> ,�x.0005 $ <br /> _.......�- <br /> (cnnrr�cl priCc) <br /> 3. POS'1'AGE Rt HANDI.ING(Only on Mail-in nppliCElliUns) $ 2,00 <br /> a. TOT��,�GRMrT�+��(�dd Li»es 1-3 �.liovc) g <br /> � * CONTRACT PRTCr or .1013 CUST me�ns thc actual or esi.im.ttcd doli�r �»>ount ci�nrged For tiie <br /> per�nitced worlc including materiflls, labor,profit,�.nd oChCr fxed coSts. 1t is the Amount to be cla�rgcd <br /> to the customer for the work done, if tlny m2tcrial, equipment, labor or inst�llations e�•e fin•nished by <br /> the owncr,tcnant�r any other pa�fiy,the re�sonflble marlcet vc�lue oF such it:ettts must be �Iddcd fc�cl�c <br /> CStitnatCd cost or COritfACt �iticc f�r �ermit fec ptirposes. 1n the cvcnt tha.t tl�crc is a dis��utC or tlie <br /> �moune o�f the joU eos�., tl�C Cily may request lhe Subtt�lssion of a siBnCd copy of thc actual con[rflel. <br /> ,�.,. �� <br /> _; .. � �rnr��rER�rr�:�r�;rc��r���r�r�����Nx� � ..� <br /> Tlie undcrsigncd liereby applics to thc Cit:y fo�• issuanec o('a Plu��nbing Permit, a�recs to dc all <br /> wor!< in 5trict accotdancc wicli thc ordin�nces oi'thc Ci1:y ai�d Lhc rcgUlE]t10f1S af tt1C Stfl1r, oi' <br /> Minnesc,ta, and certifics thac all st�l;ements madc on this applioatioi� �rc CC71ll�)�elC, truc and <br /> corrcct. <br /> Applicant's Sign�thrrc: /�-' p11�: < <br /> _.,,.,_ - -I.� 1�,> _ <br /> 3 <br />