AF - 46242�]
City of Fridley, Minn.
BUII.DING PERMIT
nase: . . . ."T.. " °� .3 .: . �?. . ...`'l . . .. .. .. ...
�
N° 3812
Owner � ............... ........................ Builder ��7/. G.�l.�!t� ./C.�� �-'."!{!:'�'.i ��. • : " t.
Addreas...................................... Address .............................................
LOCATION OF BU[LDING
No. .I i�O.� . S1rnet ....`.^.'�Y....R/„2(�!'�•.......... Part of LLot .........�.j..�. f.-....�.. .�...�%
Lot ...cQ'�..... Blodc ... a�,.......... Additlon or SubDivisi��lie!�.fe4Wr... /.W..�aOt �.�P.f ....
. � ry / � p
Corner Lot . .. . . .. .. .. . 7n�de Lot i�. . . .. .. ... 3etback � : �.. . 9ideyard .. �%-.Q .. .. ...... .. .... . .
DESCRIPT(ON OF BUILDING
T�U :
...`. ..... r�m f�.?�.'Q" � ��' =%a H�t 1.9..:'a'sn. �.10..�?�' �. �.�s!'I..S
�/ �1 v '�' (, �/�
. ... I]ont .�l.:. �Depth qF l:'� H�a/gpht� C►�4 . a. S4. Ft. F��7. C.Si. Ft. ..T. S!
Typc ot . trucbon ................. Fat. coec. 1�� 7.D••/•.a.�..". To be Completed ...................
In aon�deratlon of the iseuance to me ot a pexmit W construct the bui�diag de�a'bed above, I agree W do
the propaeed work in acoordance with the des�aiption above set forth 3n campliance with all provlsiona oP
ordfnances of The city of FY�idley. _ D `
„?�' . . . . . . . . . . . . . . . . .��`'. . � 1�����7�.
In cansideratfon of the P�ent of a fee of���...��..� Perrmt la herebY B�ted to ...................
......................... to construct the bulldinC or addition as described above. This Permit is �anted upon
the exprnss conrliti� that the peraon m whom it 1s gianted and hta agents, employees and worlunen, in all work
dwie in, around and upon said building, or aqy patt thernof, shall conform in all respects to the ordinancea of
FridleY. Minneaota regarding ]ocation, oonshvction, alteration, maintenance. repatr and moving of build'm� wlth-
in the city limits and this pernvt may be revoked at eny time upan violation of any of the pmvisions of said
ordinances. / .
: (. . .. . . . . �.,. Buildin6 InaPector
NOTICE:
This permit doe� not cove� the eonatruotion, Installation or altention for wi�inp, I
sewer o� watsn Be wra to see the Buildiny Inspeotor for separate permib for thase
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City of Fridley 16 3 9 3
�
� ATTHETOPOFTHETWINS BUILDING PERMIT - �
� ' RE
� �
� � ____ COMMUNITY DEVELOPMENT DIV. c J�
r � � � PROTECTIVE INSPECTION SEC. /�3 / O
1
1_---� �"'�'� CITY HALL FRIDLE� 55dS2 NuMBER nEV OaTE PwE OF nPVPOVED BY
612-571-3450 si0-Fi5 9/16/81 � �
lOB AD�RESS y008 Hacl�ann Ci.rcle N.E.
1 LEGAL LOT NO. BLOCK TRACTOR ADOITION SEE ATTACMED
oesca. 25 2 Parkview He1QY1tS SMEET
2 PROPERTYOWNEN MAILAD�RESS 21P PHONE
Curtis W, Acree 1008 Haclrmann Circle N.E. 571-4048
3 CON7RACTOR MAIIADDRESS ZIP PHONE LICENSENO.
Same
d APCMITECTORDESIGNER MAILADORESS ZIP PHONE LICENSENO.
5 ENGINEER MAILA�ORESS ZIP PHONE LICENSENO.
6 � USE OF BUILDING
Residential
7 ClASSOF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 � DESCRIBE WORK
Convert existirn,� attached garage to livinq area
9 CHANGEQFUSEFROM TO
STIPULATIONS
;EpERA7E PERMIT5 REQU�RED FOR WIa���,
HEATlNG, PLUMSING AND StGNS.
SE7ARATE PERMITSARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OP CONST. OCCUPANCY GROUP OCCUPANCV LOAO
VENTILATING OR AIR GONDITIONING. . .
TNIS PERMIT BECOMES NULL AND VOID IF.WORK OR CONSTRUCTION ZONING SO.FT. CU.FT.
AUTMORIZED IS NOT COMMENCED WITHW BO DAVS�, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT �
ANY TIME AFTER WORK IS GOMMENCED, .� NO. OWLG. UNRS OFFSTREET PAAKING
I HEREBY CERTIFY TMAT 1 HAVE READ AND E%AMINED THIS APPL�CATION �- STAlLS GARAGES
ANDKNOWTHESAME708ETRUEAN�CORRECT.ALLPROYISIONSOFLAWS yp�UATION SURTq%
AND ORDINANCES GOVERNING THIS TYPE OF WOPK WILL BE COMPLIED p
WITH WHETHER SPECIFIED HEREIN OR NOT. TME GRANTING OF A GERMIT Sl�OOO � y. SO
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMITFEE � SACCHARGE
PROVISIONS OF ANV OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCT6 N � HE 7EflFORMANCE OF CONSTRUCTION- � S17. SO �
/' ."�- PLAN CHECK FEE TOTAL FEE
%A� j $18.00
S�GN>TUNEOFCONTfV<LTOROR<pTHOHIZE�FGENT 7 �onTEi WHEN PROPERIY VAUDATED THIS IS vOUR PEFMIT
(
SiGNRTUPEOFOWNERUFOWNERBU�LDEP� iDNiEi B�OG iNSP /D *E�
CITY Of FRIDL[Y Effective Aug. 1, 1981
APPLIGITIOP� FOR RLSI�EiyTIAL (iUILDI(!6 PLRi�ITS
{Ne�•r, Alterations, AddiLions, or Repairs)
O�1taER: �,� L1.,�. C��,t.`/L-e��
ADDRESS : �GaO .�G�.,
TEL nl0: �6 �
STRT:FsT NO: �O STREE
LOT: v7� BIACK:
RUILDER
ADDR[SS:
rE� r�o:
___�1
�S'c�..�. � .�^
s ��
Corner Lot: Insicle Lot:
� ADAITION: PA,2C! UiE_t_.C) Q�J6 f�T�
SetbacY.: Sideyards:
Ap�licant attach to this form two Certificates of Survey of lot and
pzoposed building location drawn on certificates to scale.
� ��� DESCRIPTIOiV OF COFlSTRUCTIOf�
� .
Tmnt : Depth :
a�'t"�'�" Square Feet: Qibic Feet:
Front:
�P�=
Height:
Heiglit:
Squar.e Feet: Wbic Peet:
pa
''q �
7ype of Corstruction: w �,�L� Estimated Cost: $/� �� �
7U Be Cbr.�pleted: � �,V
Alt. A Alt. 8
Proposed Driveway Width If New Opening Is Desised• $ $
S�E RF.VERSE SIDE OF SHEET
1he undes sianed hereby maken application for a permit fcr the �:ork herein specified,
a9reeing to do.all work in strict accordance with the City of I'ridley Osdinances and
ruli�igs of the De�klrt�ne�t of Buildings, and heseby declares that all tl�e facts and
repres�ntations stated in this application are ue and correct.
DRTi: �O SIGNIITURE: Ci(/�
Stipulations:
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City of Fridley
AT THE TOP OF THE TWINS
�,
� . �� � COMMUNITV �EVELOPMENT DIV.
� v � � PROTECTIVE INSPECTION SEC.
r ,
�
� � /"'1 � CITY NAIL FflIDLE� SSd32
i-'-'� � ,'' 612-571-3450
lOBAODRE55 1005 Hackmann Cizcle NE
1 LEGAL
OESCR. 25 Z
Su9�ECT
BUILDING PERMIT
NU�BER AEV W1E p�GE
910-F15 6/25/43 �
' OP AODITION
Parkview-Heights Addition
21933
REC
oi0��
Of RPGROVED BY
�
SEEATTACHED
SMEET
Laurie Koehler 1008 Hackmann Circle NE 558-0771
3 CONTRACTOR MAILA�DRESS ZIP PHONE LICENSENO.
'Itvin City Storm Sash Ihc. 1QS25 Greenbrier Rd, Mtka MN 55345 546-8160 3090
.............�..e..«�...��e uui enneeec ZIP PXONE UCENSENO.
5 ENGINEER
6 USEOFBUILDING
Residential
7 CLASSOFWORK � NEW
8 DESCRIBE WOAK
Replace sashes
9 CHANGE OF USE Fi70M
❑ ADDITION ❑ ALTERATION ❑ REPAIR
%
LICENSE NO-
❑ MOVE O REMOVE
STIPULATIONS mstall smoke detectors as per UBC 1210 - adjacent to all sleeping areas
and in basement, Habitable xooms shall have not less than 10 percent of room floor
area as glazed op�inqs with a minimum of 10 square feet per habitable room. Window
must meet the State Building Code for egress windows where applicable and not be
reduced in size.
SEPARATE PERMIiS ARE REOUIREO FOR ELECTRICAL, PLUMBING. HEATINCa.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTMORIZED IS NOT COMMENCED W�THIN 60 DAYS, OF IF CONSiRUCTIDN
OR WOFK IS SUSPENDED OR ABANDONED FOR A PERIOD O: 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED. �
I HEREBY CEHTIFY TMAT I HAVE FEAD ANO E%AMINED THIS APPLICATION
ANO KNOW TNE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIED
WITM WHETMEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A OERMIT
OOES NOT PRESUME TO GIVE AUTMOFlITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW HEGULATING CON-
STRUCTION OR THE PEFFOPMANCE OF CONSTRUCTION.
fVPEOFCONST. OCCUPANCYGROUP OCCUPANCVIOAD
ZONING SO.FT. CU.PT.
NO. DWLG. UNIiS OFFSTREET PARKING
1 STALLS GARA�ES
VALUATION SUFTAX
$%%y� $4,4QQ $2,20
$72.Q0
Fire SC $4.40
' L�cense SC $5.00 I $83.60
SiGNNTUREO�CONTRACiONORAUTMOf1iZEDI•GENT ID<�Ei WHEN P PERLV VALIDATED THI515 VOU
... _ .... ..... .. . .. _ _... ._ _. _ .__.... ._.
xEw � � `�n��� a
ADDPt [ ] CITY OF FRIDLEY
ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Suilding Permit Application
Construction Address: /O� �% L�lh C�P /' (• L
I,egal Descrip8on:
Effective 1/1/93
��
Owner Name 8t��rGITY����Uih ,� ����2n Tel. A 55 �-.> %'7�
Contractor: 10825 GREENBRIER ROAD MN LICENSE # G� G.
Address: � 612-6A6-81Q0 _ Tel. #
Atiach to ffiis application, a Certificate of Survey of the
lot, with the proposed consh-uction drawn on it to scale.
LIVING AREA: L.ength
GARAGE AREA: Length
DECK AREA: Length
OTHER:
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height Sq. Ft.
Aeight Sq. Ft.
Hgt/Ground J Sq. Ft.
Corner Lot [) Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Construcfion: ���.r_3 �o � �1 /n o Estimated Cost: $ . ��bD •
Approx. CompleGon Date:
(Cost on Back)
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ _$
DATE: � _aa _ 9� APPLICANT: �/5 , f < �'ll�/�_ Tet. #
CITY USE ONLY
Permit Fee $ o� -� Fee Schedule on Reverse Side
Fire Surcharge $ `% '�b .001 of Permit Valuation (1/lOth%)
State Surcharge $ , p $.50/$1,000 Valuation
SAC Charge $ $750 per SAC Unit
License Surcharge $� $5.00 (State Licensed Residential Contnctors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above .
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STtPULATIONS:
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OC R 0 N S T R 0 M S ST. LOUIS P RK, MN 55426 1ob Nom� ��� ^� t'2---
HEATINGANOAIRCONOITIONING,INC. j2O-SBOO
Pss 1ob Addrs
N�AT LOSf CALN�AiIONf '
Weatherstrips A G��� Conatruction No. losulation
Windows Doon Refereoce Out. Wpll Int. Wall Ceiling Roof Floor I I Kiod How Applied
Y e s— N o I Y e a— No I 19_ I I
� FI,� Room L.eogth V/idth Height II Fl.� Room Length W�dth Height
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Ceiling /udS �f o�
Floor2�yYs I�L�XS — L�o
Total Btu. 3 79 S3
Required aq. ft E.D.R. or p. in�. W.A. Leader area Q+��
F7.� Room Length Width Fkisht
Wiadowa and Door►—Crscka`e and Arca � S�� 84ti1
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FRIDLEY
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�
FR[DLEY MUNICFPAL CENTER • 643] UNIVERS[TY AVE. N.E. FRIDLEY.;�1X Si432 •(6121571-3450 • FAX (6121571-I?87
September 21, 1994
Ms. Laurie Koehler
1008 Hackmann Circle NE
Fridley, MN 55432
RE: Furnace Replacement at 1008 Hackmann Circle NE, Fridley
Dear Ms. Koehler:
Thi5 letter is to confirm our conversation of September 20, 1994
concerning the furnace replacement at your home.
On or before October 15, 1994, I will expect a time schedule for
the completion of the furnace replacement in your home.
UBC Section 104(b) states that a condition such as the condition in
your home is unsafe and shall not be allowed. If necessary, I
shall exercise my powers under UMC Chapter 2(see attachment).
Please contact me at 572-3605 if you have any further questions.
Sincerely,
EL COLL VA
Mechanical Inspector
MC/mh
ATTACHMENT
CC: Cronstroms
Minnegasco
Heating & AC
R`
r -
_
UlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. M\ i�d32 •(61 21 57 1-3d50 • FAX c6121 571-12H7
September 21, 1994
Ms. Laurie Koehler
1008 Hackmann Circle NE
Fridley, MN 55432
RE: Furnace Replacement at 1008 Hackmann Circle NE, Fridley
Dear Ms. Koehler:
This letter is to confirm our conversation of September 20, 1994
concerning the furnace replacement at your home.
On or before October 15, 1994, I will expect a time schedule for
the completion of the furnace replacement in your home.
UBC Section 104(b) states that a condition such as the condition in
your home is unsafe and shall not be allowed. If necessary, I
shall exercise my powers under UMC Chapter 2(see attachment).
Please contact me at 572-3605 if you have any further questions.
Sincerely,
/
EL COLL VA
Mechanical Inspector
MC/mh
ATTACFiMENT
CC: Cronstroms Heating & AC
Minnegasco
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CfIYOF
FRIDLEY
.
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612).571-3450 • FAX (61 ) I-I _
December 9, 1994
Ms. Laurie Koehler
1008 Hackmann Circle NE
Fridley, MN 55432
RE: Furnace Replacement Violation at 1008 Hackmann Circle NE
(SECOND NOTICE)
Dear Ms. Koehler:
I have been in contact with your heating contractor, Cronstroms
Heating & AC, and have learned that your heating equipment is still
in violation of numerous building and mechanical codes, i.e. UMC
Chapter 6, UBC Section 104, UMC Section 405, and UMC Section 504.
Be advised your heating system is not in Code compliance,
therefore, it is considered unsafe and shall not be operated until
the installation is completed by an approved agency.
You have 5 working days to respond to this letter. Please contact
me by telephone at 572-36�5 or in writing at 6431 t3niversity Avenue
NE, Fridley, MN 55432.
Sincerely,
/y ���
///,;
`"=�/ i�`c%/'�.��✓
MEL COLLOVA
Mechanical Inspector
MC/mh
CC: Cronstroms Htg & AC, 7201 W Lake St, St Louis Park, MN 55426
Ray Thompson, Minnegasco, PO Box 1165, Mpls., MN 55440-1165
s�s�EC*
City of Fridley
.,
•'T�E'°°°F'ME,�'"5 BUILDING PERMIT
.
� � ��� COMMUNITY DEVEIOPMENT DIV.
r � �'� � iqOTECiIVE INSOEC710N SEC.
, ; .
i..-_� �"' �•� CITV XALL FRIDIE� SS�Jt NUrBEa M
L 612-571-345U 910-FIS
JOB ADDRESS 1008 Hackmann Circle NE
t LEGAL �OTNO. BLOCK �NAGTORADOITION
OESCR. 25 2 Parkview Heig
t PROPERTYOWNER MAIL�DDRE55
Paul JorQenson 1008 Hackmann Circle NE
Reroof House (18
S OF WORK
O NEW
8 OESCRIBE WORK
OFUSEFqOM
STIPULATIONS
�ooness
fE v�GE OF
5/10/OQ J /
30934
/3
B%
SEEATTACMED
SMEE7
VMONE
763-571-5118
iMONE LICENSE NO
Tear-off
❑ ADDITION ❑ ALTEMTION � REPAIR ❑ MOVE ❑ REMOVE
Underlayment must comply with the State Building Code.
SEPARATE PERMITS AqE REOU�AEO FQR ELECTRICAI. PLUMBING. ME�TING. ���� ��
VENTI�qTING OR 111R CONOITIONING
THIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENLED WITHIN 60 OAYS, ON IF WNSTRUCTION
OM WORK IS $USPENDED OR ABANOONED FOR A PERIOD OF 120 D�YS 11T
ANV TIME AFTER WORK IS COMMENCEO. NO DWLG
1 NEREBY CENTIFY �NAT 1 MAVE NEAO ANO E%AMINEO TMIS APP�IC�TION i
ANOKNOWiMESAMETOBETRUEANDCORRECT.ALLPROV1510NSOF�AWS yA�UAT10�
ANO OFlDIN�NCE$ GOYERNING THIS TVPE OF WORK WILI BE COMPLIED
WITN WMETMEA SPEC�FIED NEAEIN OR NOT. THE GRANTING OF A VERMIT �1>S73
OOES NOT VRESUME 70 GIVE AU7NQRITV TO VIOLATE OR CANCEL THE pEpMITfEI
�POVISIONS OF ANY OTMER STATE OR LOCAI lAW REGULATING CON�
STRUCTION OA TME PERFORMANCE OF CONSTRULTION $57.05
•UAEO�CON'P�CfOAOA�UTMOA�LEO�G�Ni �p�iE�
STA��S
CU iT
$.79
•CCNARGE
Fire SC $1.57
DTALFEE
�59.41
NEW []
ADDN []
ALTER [ j
Construction Address:
Legal Description: _
Owner Name 8 A/�ddre
Contractor: / /%�
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
EffecNre 1/12000
CI'fY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Tel. #
MN LICENSE #
l�f,� Tel. #
Attach to this applicatron, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCWP'T10N OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length � , Width HgtlGround Sq. Ft.
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x S =$ l�!-3
DATE: APPLICANT: Tel. #
CITY USE ONLY-
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572J604 for Pertnit Fees if mailing in application
$ �� �� Fee Schedule on Reverse Side
$ %� S 7 .001 of Permit Valuation (1/10th%)
$ �/' $.50/$1,OOQ Valuation
$ $1100 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or AR. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Pfecessary [ ]
$ �9� yL
!
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 57I-3450 • FAX (612) 571-1287
Dear Property Owner:
Effective January 1, 1992, Minnesota Statutes require that most residential building
contractors, remodelers, roofers, and manufactured home instaliers be licensed by the
state. Speciaity contractors who perform only one special skill (e.g. concrete &
masonry, excavation, carpentry, interior finishing) are exempt from state licensing.
Contractors who generate less than $15,000 in gross annual receipts are also exempt
from state licensing, but must obtain a certiflcate of exemption from the Minnesota
Department of Commerce.
The state license number of a residential building contractor must be placed on all
building permits and permit applications issued by a city or county. A license number
must also appear in a site plan review and all zoning permits. Cities and Counties are
prohibited by state law from issuing permits to unlicensed contractors who are
not exempt from licensing. In addition, it is a misdemeanor to perform
contracting work without a license unless the contractor is exempt firom
licensing.
State licensing is intended to ensure a minimum level of competency and to afford
consumer protection. To accomplish these goals, I�censed contractors must pass a
two-part examination relating to the construction trades as well as business
administration and law. Licensed contractors are also required to take seven hours of
approved continuing education each year and provide proof of liability insurance and
workers' compensation insurance (if required by law) as well as business ownership
documents to the state. Also, licensed contractors and remodelers must contribute to
the Contractor's Recovery Fund. . This Fund is intended to reimburse homeowners who
obtain judgments of up to $50,000 against licensed contractors and are unable to
collect on theirjudgments. Homeowners who use unlicensed contractors will forfeit
their rights to access this Fund. Licensed roofers and manufactured home installers cio
not participate in the recovery fund, but instead are required to hold a surety bond in the
amount of $5,000 and $2,500 respectively.
Contractors are licensed and regulated by the Minnesota Department Commerce. To
determine the licensing status of a particular contractor, call the DepartmenYs Licensing
Division at (612) 296-6319 or 1-800-657-3978. Complaints against iicensed contractors
can be directed to the Department of Commerce, Enforcement Division at {612) 296-
2594 or1-800-657-3602.
The license number of a licensed contractor must appear in all advertising, business
cards, lien notices and statements, contracts and proposals.
�
_
CITYOF
ERIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
BUILDING PERMIT APPLICANT: HOMEOWNER
I understand that fhe State of Minnesota requires that all residential buiiding
contractors, remodelers and roofers obtain a state license unless they qualify for a
specific exemption from the licensing requirements. By signing this document, I attest
to the fact that I am building or improving this house myself. I hereby claim to be
exempt from the state licensing requirements because I am not in the business of
building on speculation or for resale and that the house for which I am applying for this
permit, located at , is the first residential structure I
have built or improved in the past twenty four (24) months. 1 also acknowledge that
because I do not have a state license, I forfeit any mechanic's lien rights to which I may
otherwise have been entitled under Minn. Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractprs may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractors Recovery Fund * in the event that any contractors
I hire are unlicensed.
Signature of Homeowner
Date
• Licensed residential Duilding contradas and remodelers are oovered by fhe recwery fund. licensed residential roofers and
manu(acWred home fnstallers are not covered by tha recovery fund but are required W hold a surety bond.
To determine whether a particular cootractor is required to be licensed, or to
check on the licensing status of individual contractors, please call the Minnesota
Department of Commerce, Enforcement Division, at (612) 296-2594, or toll-free at
7-800-657-3602.