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• 04-11—'18 10:52 FROM— 1-777 P0003/0004 F-253 <br /> %c'Y., f C^� -�'- 7�..4r � ■' c c.r�,l' .r �,y i ^FY� s. 's � ,�.-• ;1 1_.� t�' <br /> , ?+ .ti �^ lZ5t..' 31ria � �b�6 i}�r1a L�/cd, 10it/iPJatVti ,g, 1 '4 Cr A �..', <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.004 <br /> I3//-7 x.0125$ 112• <br /> (cult-act price) (minimum$50.00) <br /> 2. STATE SURCHARGE (, 0 1¢314 x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $—Ma_ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> 11q 'iq <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 the <br /> 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 amount <br /> of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> i'��iw tsr �K}'�a �.c aid' s, Y J-7� � �,�;-� it "i �. gyoo `�f d o , -y77-a- ):� <br /> t s 3a �a ,�a: . . e � �_ s.4,!4��.[Jra�.e 7���i _�1�1 .itI .z::e: _` s45 <br /> The undersigned hereby applies to the City for issuance of a Mechanical 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 a•• .tion are complete,true and correct. <br /> Applicant's Signature: i /1" <br /> +�, Date: i"1 4 g <br /> 3 <br />