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t <br /> WJ„ k {�j "��'^ _iarf ; .. D t, Y f;� {y,�)wN.3'"}) �•` ,e� 1aSeS�p�i'S 5.?" � -'. <br /> s- `, ...::max?-S i i , is +.J A: �r ci, ;,sN,"..'_:; .. V.,., ',.., «t:., '> ., _ ,. .. ..< . <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> 1 0 5'0 x.0125$ <br /> (contract price) (minimum$50.00) <br /> 2. STAT SURCHARGE <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL.PERMIT FEE(Add Lines 1-3 Above) $ <br /> • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work ncluding materials, labor,profit, and other fixed costs. It is the amount to be charged <br /> to the customer or the work done. If any material,equipment,labor or installations are furnished by the <br /> owner, tenant o any other party, the reasonable market value of such items must be added to the <br /> estimated cost o contract price for permit fee purposes. In the event that there is a dispute on the amount <br /> of the job cosithe City may request the submission of a signed copy of the actual contract. <br /> C. b...s'u..�: S[Rk .r .t�.x.y TY .+,a r8;a .„4d`< 4x, w t1#..o-:. .e tw _ rt _.. , ,e . -. <br /> The undersigned hOreby 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 application are complete,true and correct. <br /> Applicant's Signature: /la 0Date: g:-�� / K <br /> 3 <br />