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. <br /> . <br /> If above does not apply;follow guidelines below: <br /> 1. �ONTRACT PRICE *is 1.25%of contract price wifh a(Minimum Fee of 550.00) <br /> ��7_.�Ca.��'; X.aias$____I %>.t:�� <br /> (conlreCt price) (minimum 550.00) <br /> 2. STATE SURCHARGE <br /> `6"�`�C;y.rto ,�.000s $ y�l <br /> ccoatr8�t Price� <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) � ..�:66-- <br /> 4. TOTAL PERMTr FEE(Add Lines 1-3 Above) $ �(j'��v�� <br /> • * CONTRACT PRYCE or dOB CUST means the actual or estimaxed dollar amount charged for the <br /> permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material,equipment, 2abor or install�.tions are furnished by <br /> the owner, tenant or any other party,the reasonable market value of such items musf be added to the <br /> estimated cost or contract price for permit fee purposes. Tn the event that ihere is a dispute on the <br /> amount of the job cost, the City may raquest the submission of a signec! copy of the actual contract. <br /> The undersigned hereby applies to the City for issuance of a Pliunbing Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certi�es that all stabements made an this application are complete, true and <br /> correct. <br /> APPlicant'S Sig�gtu�'e: ___`�L�.•u(���_ Date: �.F' 'I�`I k/�',7 <br /> 3 <br />