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iy e .,- µ <br /> u ,r. .. .E _, ...a.�q'.:m,i�viluv�i�,dMbil ,� <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> 23i GUS x.0125$ 8'7 <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE // <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ / 9 5?0-0 <br /> • * CONTRACT PRICE or JOB COST means the actual or estimated 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, labor or installations are furnished by <br /> the owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> The undersigned hereby applies to the City for issuance of a Plumbing 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 certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: �—`- /� Date: / ��� Z- <br /> 3 <br />