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09/09/2014 14:12 FAX 95293a5049 CtiLLIGAN MNTKA f�004 <br /> � , . , <br /> :,�f. ,;,�.�„ ����;,;:" •;'PE�:���,�£'��'iI:'�, = ��AT��1'�T';S� t'-�O��S�'•O��$S�Dd:mO"'�,;�"' ���,�:,, , <br /> ;,,, <br /> If above does not apply;follow guidelines below: <br /> l. CONTRACT P1tIC� *is 1.25%of contract price with a(Minfmum Fee of$50.00) <br /> x.p]25 S <br /> (contrnct pncc) (minimurrl 550.00) <br /> 2. TA'I'E SURCAAIiC�; '"*Add the 5tatc Bldg Code Div.Surcharge(M;bimum Fee of SS.00) <br /> x.0005 $ <br /> (ContrnC�prite) (minimum S 5,00) <br /> 3. POSTAGE&HANDLING(Only on Mail-�n Applica[ions) $ 2.00 <br /> 4. TOTAY,pERMIT FEE(Add Lines 1-3 Above) $ p�,�.tl V <br /> � * C4NTRACI' PWCB or JOB COST means the actual or estimatcd dollar �ount chaaged for ihe <br /> permitted work including ma#eri�ls, lebor,profit,and other fixed costs. 1t is the amount to bc charged <br /> to Yhc customer for the wozk done. If any materisl, equipment, labor or installations are fumished 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 /> emount of the job cost,the City may request[he submission of a signed copy of the actuEli contrac� <br /> ■ **The STATE 5[JRCHAIZGE is.00OS of thc contract price under 51,000,000 or$5.00—whichever is <br /> grtatcr_ For valuations over$1,000,0�0 call tht Building Department at(952)249�4600 for the price. <br /> ,i�f' � :� 1'. .F..1 ;�,n G M �. .'" .�•k .r�nyi .��� ��,'.�d.��r. ]II"G� 1�` .�1. <br /> �t� <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, Agrees to do ail <br /> work in strict accordanec with the ordinanees af the City and the regulations of the State of <br /> Minnesot� and cer�ifies that al] statements made on this application are compiete, true and <br /> correct <br /> Applicant's Signature: �� Date: 1' �' � <br /> ,} <br /> ' r� � ��.n�z•�. <br /> i <br /> 3 I <br /> I <br /> i <br />