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2016-01363
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Bayside Road - (AKA: Co. Rd. 84)
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3960 Bayside Road - 05-117-23-22-0016 - 2nd New PID
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3960 Bayside Rd - 05-117-23-22-0015 - 1st New PID
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Permits/Inspections
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2016-01363
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Entry Properties
Last modified
8/22/2023 5:19:55 PM
Creation date
10/28/2016 9:34:50 AM
Metadata
Fields
Template:
x Address Old
House Number
3960
Street Name
Bayside
Street Type
Road
Address
3960 Bayside Rd
Document Type
Permits/Inspections
PIN
0511723220016
Supplemental fields
ProcessedPID
Updated
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_,r,, _ — -- --- � <br /> � � PERR�iIT FrE CALCULATIONS � � �� <br /> �__-�_��--- — -- <br /> L C:OV'IRAC"I'I'RtCE * i. 1.2�°��of contract price u�iih a{39inimum Fee of��(l.Q�i) <br /> b <br /> ";C{, �{c, ^� x .o t 25 S i15 �� 5't� _ ; <br /> IcoNract pncrl (mEnimum 5�00�)) <br /> i <br /> $ <br /> 2. STATE SURCf1:�lRCE � <br /> '��1�C.lZ� x .o�xt5 � 1�'. .�� ' <br /> � �_ � � <br /> tconU�rl pritri � <br /> :;. I'(�STAGF R i�1ANnI.ING fOnlv��n !�fari-in rtppliratic�ns'} $ 3.(1�1 _ ? <br /> d. l�U'i:�L PL:tttiTt'1'FEE(Add L.ines 1-3,�Lar�vc:) S ��� <br /> ■ * CO�v�I�RACT PIt1C�: �7r JC)F3 CUS i me�ns thz actual or estimatrd doll�r anzt�unt cE�ar�ed fue ti7e <br /> pennittr�l w�ork inrluding materials. labf�r,proti�.and e�ther tixed custs. It is th�amount to br.�har�Lci <br /> t«thc custorner t2�r the wurk dune. tt 3ny matcrral.e�Gtipm�nt,labc�r or insCillations t�rc furnishc,!hv r�74 <br /> owncr, teuarzt or any other psrty, thc re=3ionabic rt�arket vulue of such items must be ad�ie�! +u �he <br /> esum��tcd cost or ec�ntract price I�or pennit fce pur�c�ses. in tt��e���nt th�t there is a dispute+�s3 the arn4xt�s�t <br /> caf th� �<�t� cos�, tl�c Cit�� rnav requ�st th� :ulrniissrc�n of a si�ne�i copy of the actual coiiti�����;. <br /> , ; :. � � I,�NIC Q.L PFRMIT r�PPI.IC'AT1C7N ACiREFIVI�NT , <br /> � _ <br /> - '�tECI � ' <br /> � J � ,, <br /> _ ,..,r <br /> _._._ . _�_ ._ _____.._________— — _ ._.___.__� �..__.::i <br /> The undersigned f�er4by ap�iies tu the Cit�� Cczr issuance of a '��fechanic�l �'ennit, agrees tc� c�« .a11 <br /> ���ork in strict accordauc� with th� c�rdinances of the Ciry and the re�tilations c�f thc Statc ��f <br /> �1i��nesota,and cc:rtifics that all statements inade on this a�plieation arc complcte,truc and rorr�et. <br /> ,.., <br /> ..-~��.�� �_ <br /> -''%' �,,-'/ � <br /> r� <br /> Applica�t's Signature: � .�'� �'� '`"� __.._..� Date: ! .. `�1� ���'.� �'��_ <br /> r �— � <br /> ✓`� <br /> � <br /> i � <br /> � <br /> � <br />
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