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12/14/2015 14:05 FAX 9529335049 CULLIGAN MNTKA iiP 004
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<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 /> x.0125 S
<br /> (contract price) (minimum t50.00)
<br /> 2, STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00)
<br /> •
<br /> x.0005 $
<br /> (contract price) (minimum$ 5,00)
<br /> 3. POSTAGE&HANDLING(Only on Mail-1n Applications) $ 2.00
<br /> 4. TOTAL PERMIT PEE(Add Lincs 1-3 Above) $ I g• C b
<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 STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is
<br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
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<br /> �d i i •��'' I@1, �;'";"i,"71'��.er,JIYYi,o,.�'�{Lt''..r:'.�,
<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: 97G Date: 11- 11- I I____
<br /> y6 es' ,hlror,' F1c
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