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J�n-OB-20D2 12:18pm Fro�-CITY OF OR0�0 +DB22484616 T-461 P.OD61006 =-76T <br /> � � ` . <br /> � - . <br /> P ' f' CiJLATION' <br /> I. 1,259b of Contract Price* or �fn-i�m� .,um Fe� (;6�.'iS.001 . <br /> �.�.L..[,�6 ` � � x .0125 $ � . � <br /> (coacract giice) <br /> �. State Sur�h�'�e. �* Acid tl�e S te Bi�itdi.ng Code Dlv3sion <br /> � Surcuar�e.w e�cch pcm�It. �+a5 `� x .Op05 $ P- <br /> ( :uracc�ice) � . <br /> or$.$0, whichever is �reater <br /> 3. �stas� and Handl� (ONy mail-i�n appllcations) $ � 1.5 <br /> . 4. TQTAId PEI�MIT �EE (Add liaes 1-3 abave) � _��_�� <br /> * C4NTRACT PRlGE or dQ�CQS"f mcans the actua!�estis�ated doIlar atuouat eha�'ged for tha ger.�ittcd <br /> work includlag �tetiata� labor, pmfit. and ot3us fuod casts. Ic �S the mmp�unt,to (�e charge� tp, � <br /> tqsoomor f�thc work done. If aay sqaterial� equip�t�l�bo:�or iast�tiaa are fu�istted�y the owner, <br /> tenaat or any other party tbe reasa�eahIe tparicet value Qf such foem.s�tvst be�lded to ihC estimated cast <br /> ar coauaa priee far perm[t�p�uposea. Ia the cvent thaz ch�'ss a disput�on c�e�moQat of tbo job cost, <br /> the Ciry�i'r�cluast the sabmissio�n af a si�ed cogy of t�e actnaF contract, <br /> • ` , <br /> �'$ The STATE SURCHARGE it .0005 of the coatrar� prlce tmder$Y,Oad,a00 or $.50 - wh:chtver is <br /> great�x. For valu$tious ov�r$I�O�,Q00 call tbc L?epartmcnt oP Inspecuonal Servic�.s fac the pri�. <br /> The undersigne�l hereby�pplies to the City�i�r issuan�e af a Plw�.bir�Perr�it, agrees ta c�o a]1 <br /> work in strict �cccordance with the ordinaacus af tha Gity and the regulations of the State of <br /> M�anesota, a�d eertifes that all statements made on th,is application are complete, trc�e a�ad <br /> ct�rr�f. ' . <br /> Applic�nt's Signa'ttYr�: ��������/�' Date: <br /> , ,.� <br />