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� <br /> , ,.. ,. � - �- ,....,. � � . „ <br /> - r4C. �'`:' � "„ .N. .. , ..-. . <br /> ai � ' � � � ' ' �. <br /> � r <br /> r1:�. " .._i..��,... � . •rp' <br /> t• - -,,e m...: <br /> �rs, � ... , � <br /> 3 <br /> «. -� ..i�.. .,.�..�.-, ., . .. . �-. .. . _...:5 ._ .... <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �/, `/'DO� x.0125$ <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) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� '�D <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 /> � � �. :��� . �. av b.. . .�. . <br /> ,��.,�,� ��� �. �. � ��y <br /> � � ° � �, <br /> � <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: �����%�-c_ Date: j�vZ��i�ZOl.3 <br /> 3 <br />