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02/09/2015 14:�5 FAX 9529�a5049 CtTLLIGAN MNTKA �004 <br /> ;+.f ����fAr�"��t��y1�1���,',[`r�3i'�.,:i++%w!;���'' � � �' � W�j�ir .����',�v�^�t� '��y�7;`�'`';�'�;'1�r�.`,*M� S����i. <br /> r •a 1 a��v i „ui� ..G.,� .:.�A+d.tiiF7. ��M�.,�°�j'. "�iJ`�.''� <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT pRICE *is 1.25%o�contract pricc with�a(Minimum Fee of$50.00) <br /> x.0]2S$ ' <br /> (conqaC[p�Ce) (minimum$50,00) <br /> 2. 'f' TE SURCHAItG� '�*Add thc State Bldg Code Div.Surcharge(Minimum Fa otS5.00) <br /> x.00OS $ <br /> (contra�t prieC) (minlmum S 5.00) <br /> 3. POSTAGB&HANDLfNG(Qnly on Mail-In Applications) � 2.00 <br /> 4. TpT,a1X,PERMIT FEE(Add Lines 1-3 Above) $ Q� <br /> ■ * CONTRACT PWCE or )dB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, IAbor,profit,and other fixed casts. It is the amount to be charged <br /> to the customer foc ihe work done. If any material,equipment, labor or instatlations are furnished by <br /> the owner,tenant or any othcr party,t�e reasonable markat value of sueh itcros must be added to the <br /> es�imated cost or contract priee for permit fee pwpnses. In the event that thert is a dispute on rho <br /> amrnmt of the job eost,the City may reqvcst the submission of a signed copy of the actual contract. <br /> ■ "*The STATE SURCFTARC:E is.0005 of the contt'act price�mder$1,000,000 or$5.00—whichtvcr is <br /> greatet. For vaivation,s over$1,000,00U call the$uilding Departrnent ai(952)249-4600 for the pricc. <br /> � � '��,•� ` �!�'y�,�, `�l'` ' '�� � <br /> u'�' �' . '.'• .��.��', I �'��r`/'�A�'711��if���r.��Vl�.�f��h <br /> The undersigned hereby applies to the Ciry for issuance of a Plumbing Permit, agrees to do a11 <br /> work in strict aeeordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that a11 sratements made on this a�plication are complete, true and <br /> correct. <br /> Applicant's Signature; Date: � � ! - ���_ <br /> ,��a' � i4� <br /> � � <br /> �ri!aMr�P'r;:!n .���S,RfJ'I�II <br /> 3 <br />