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2012-01195 (plumbing)
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4495 Bayside Road - 06-117-23-21-0004
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2012-01195 (plumbing)
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Last modified
8/22/2023 5:24:26 PM
Creation date
1/22/2016 3:45:07 PM
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x Address Old
House Number
4495
Street Name
Bayside
Street Type
Road
Address
4495 Bayside Rd
Document Type
Permits/Inspections
PIN
0611723210004
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� PERIVIIT FEE CALCULATION(S —JOBS OVER$500.00 <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �� ��U x.0125$ <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) $ <br /> ■ * CONTRACT PRICE ar JOB COST means the actual or estimated dollar amount charged for the <br /> permitted wark 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 pernut 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 /> � � <br /> �' �E�� T" � � PLj..TMB��n�P���T � ��A.GREEMENT '� � <br /> � <br /> .: <br /> ,. <br /> � . ; <br /> ' R�k �.,. <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 tl�e ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that aJ-3� statements ade on this application are complete, true and <br /> correct. � <br /> ,% � <br /> , <br /> ���� - / <br /> '' // !� 07/ � <br /> Applicant's Signature: � �I�i Date: � <br /> 3 <br />
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