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02/22/2011 12:23 FAX 9520335049 CULL MINTKA IJ004 <br /> r:0 j�-F,S ,4712Ti ti#� ^ ' i f t 77 C� '157 7, <br /> I Y '( T�6- " ��r i u!'. G17 . <br /> If above does t apply;follow guidelines below: <br /> 1. i NTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> x.0125$ <br /> (contract price) (minimum$50.00) <br /> 2. S ATE SURCHARGE **Add the state Bldg Code Div.Surcharge(Minimum Fee of$5.00) <br /> x.0005 $ <br /> (contract price) (minimum S 5.00) <br /> 3. P e TAGE&HANDLING(Only on Mail-In Applications) $ 2.00' <br /> I � <br /> 4. i I AL PERMIT FEE(Add Lines 1-3 Above) $ a.vv <br /> • • CO ' CT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted ork including materials,labor,profit,and other fixed costs. It is the amount to be charged <br /> to the cu mer for the work done. If any material,equipment,labor or installations are furnished by <br /> the owner nant or any other party,the reasonable market value of such items must be added to the <br /> estimated or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount o I e job cost, the City may request the submission of a signed copy of the actual contract. <br /> • **The S I TE SURCHARGE is.0005,of the contract price under$1,000,000 or$5.00—whichever is <br /> greater. F valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. <br /> !. <br /> e undersi ed hereby aPlies to the City fQr issuance of a Plumbing Permit, agrees to do all <br /> rk in stri• accordance with the ordinances of the City and the regulations of the State of <br /> innesota, d certifies that all statements trade on this application are complete, true and <br /> correct. <br /> Applicant's nature: ae: - l <br /> Date:g � ' � <br /> i I . <br /> 3 <br />