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01/19/2012 14:29 FAX 9529335049 CULLIGAN MNTRA Ij004 <br /> ..'al.•.,rge a . .a ,y: X4111-.1. 41 l':1'1" moi , nirierg': <br /> • <br /> If above does not apply;follow guidelines below: <br /> I. CONTRACT TRICE "is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> x.0125$ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00) <br /> x.0005 $ <br /> (contract price) (minimum$ 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.0Q <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) <br /> G iiO4 <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 famished 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 disputa on the <br /> ___amount of the job cost,The City may request the submission of a signed copy.of the actual.contrack. <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. <br /> t iia9k'1I, �ITT.•.`;.; 1 <br /> f„? <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: Aziati <br /> Date: oa <br /> • <br /> • <br /> • <br /> 3 <br />