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Nov. 28, 2016 9: OOAM No. 4577 P, 5 <br /> � . � <br /> , <br /> ,;�;�y ;-; , ,;. . . . pE�'IT F�E GAY,CCr1,ATY0I�TS . . „ <br /> 1. CONTRACT PRICE �is 1.25%of contract price wi[h a(Minimum rcc of�50.00) <br /> �� �00. �O x.0125� <br /> (conlrac�price) (minlmum SSp.p 0) <br /> 2. STATESURCHARGE <br /> x.0005 $ <br /> (cuntracl priCC) <br /> 3, POSTAGE�HANDLING(Oniy on Mail-In Applica�ions) $ 2.00 <br /> 4, TQTAL PERMIT FEE(Add Lines 1-3 Above) S / �' �`�' <br /> ■ * CONTRACT I'RICE or JOB COST mcans the actual or estimated dollar amount chaa•ged for �he <br /> perrnitted work includaa�g znate�ials, labor,profit,and other f►xed costs. It is thc amount to be charged <br /> to che cus�omer for tl�e work done. Tf any material,cqu'rprnent,labor or'rnstaIlatioa�s are furnished by tl�e <br /> owner, teaiant or any other party, thc reasonable market 'value of such items must be added to �e <br /> estimated cost or coatract price for pernnit fee purposes. In the event that there is a dispute on thc a�nount <br /> of thc job eost, thc Ciey may request the submission of a signed copy of the ach►al contract. <br /> r� r; , W��;�r�i�a�,P��T��ic;rcAr�orr������� _ . <br /> The undersigned hereby applies to the City for issuance of a Tv[echanical Pern�it, agrees to do all <br /> work in strict accordanee With thc ordinanees of the City ar�d the ;re�ulatipns of the State of <br /> Mi�nesota,and certifics that all stateme�ts tnade on tl�is application are complete,true and correct. <br /> Applicant's Signature: �� `'d��'` Date: ��/ �-fl�•�D�� <br /> 3 <br />