Laserfiche WebLink
❑ Yes,this section applies <br /> The reptacemez�t of a Residential fixture or ap�slianoc that meets aia ttuee o;Fthe following recauirements: <br /> 1. Does not require modificati,on�to eaeckdcal ox gas service. <br /> 2. Kas a otal cost of$SQ0.00 or le�s;ez�cludin�a the cost of the fixture ar appliance:and <br /> 3. Is�npz�oved,izistalled or reptaced by the homcrnmer or licerased contractor. <br /> Skip qeMt sec�,ozA,i1f kl�is applies; Cost of Perrnit � 15.00 <br /> State Surcharge �._. 1.OD <br /> Mail-In Fee(If Applicablc) $ 00 <br /> �'okal kermit Fee � <br /> .:r. ..._.,.�,_._.._._... ,._-..__.. . <br /> If above does nqt ap�ly;foilow gtt'sdelines be�ow: <br /> X. �ONTRACT PRICE *(s �.25°o o�coa�ract price with a(Minimunn k'ee o�$50.00) <br /> 18,oao ,�.oz2s x <br /> (contrnct pricc) (minimum 550.00) <br /> 2. STATE SURCH.A.RGE <br /> 'f8,d00 x.000S $ <br /> (conuact price} ��— " <br /> 3. POSTAG�&HA.NDLING(Only on Mail-In�lpplicat�crazs) $ 2.00 <br /> 4. TOTAL PE�'I"�'��(Add Lines 1-3 Above) $ � � v� <br /> ■ ' CONTR.ACT PRIC� qz JQ� C�ST trieans tkto actual or astunated do�lat' atnount charged for t��,e <br /> pennaitted work includittg mat�rials,labor,pro�it,an,d other�ixed costs. It is the amounit to be aharged <br /> to the castonrxez��'oz the work dane. I£any mataria�, equipmeaxt, labor or installations are furnisl�ed by <br /> the owner,tenant or any ott�er party,tt�e reasonable market value of such iten��s ax�ust be acided to the <br /> esti�ated cost or cont�act price for pezmit�'ee purpases. Tn the event that there is a dispute on the <br /> amount o#'the job cost,the City may reqrtest the submissxo�.o�'a sagned eopy of the actual cv�t�act. <br /> The undersigned hereby a�aZxes to tkae City for issua�ice of a Mechat�l�ca1 PeTa�it, agrees to do a�l <br /> work in strict accoz'dazxce with the ord'ui-�nces of the City a.z�d tt�e regulations of the State o� <br /> Mic�uaesota, at�d c��'t��ies that a11 stx�tements rr�ade on tbas ap�lication are complete, true azxcl <br /> correct. <br /> A.p�licant's Signat�u�e: G.� w Date: 01/�2/16 <br /> 3 <br />