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C:rTYOF
FRIDLEx
BUILD
ING PER1\/11T APPLICANT : PRISO Ilk E
RT- Y 0 W1\FE R
I, .
un d ers ta nd that the State o f tVlinnesota requires
that a1I resid tial building contractors , re odelers ndroofe S obtain a state license
unless they qualify for a specific exemption fiom theIIcensmg requirements T S applies to owners Df residential real estate who build or improve suchn
e
property for purposes of speculation or resale .
0
BY Signing dis document, I attest to the fact that I am mproving this house :for
use aad arn not builcling or imrovin � m own
claim to be exempt from the state lice�$ house fox the purpose of reselling it. I hprebl
re
o f Ullding or remodeling on speculation or for resale and that Uixe e ecause
I am not in the business
Ymg or � S permz�, located at �e house for whzcl� I am
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is t he only residential S e I base ul t 0 d11 ove
acknowledge that because I do not ha ve as tate license forfeit �t 24 months . also
rights to which I may othez-wise Stat.have been entitled undex Mixin 5 4 01 .'an ec aruc s Lien
ore , I acknowledge that I ay e ng independeceactors to rtain aspects of the constnictzon or improvement of this house and I understand that
some of these contractors may be regLured to be licensed by the State of Minnesota ,de I
rstand that unlicensed residential contracting, remodeling , and/or roofing aCt1V1' "
misdemeanor under Minn . S tat. 326 * 08211 subd . I6 and Carl also restilt in a %,=P� � is a
$ 10 , 000 . I further state that I understand that the filing o a false statement w • ne oup to
am=The City of Fridlev ma also SUltncrll=
itYal
o ca
ution and/or civil penaltizs
t applible city ordinances and/or state statutes .
I have also been informed and acicnow ledb e that by Sting mys elf as the c ont� a
thi s project, I aIne will e responsible to T he City of Fridley for comp iancefo r . oa l appicabe uin codes and city ordinances wit te v�,or � eing � l
roperty. Preformed o his
of
na ure ropertv owner
Cxo • ► yr .
ate
For qUeStiOris or in -Formation on contrac tor licensing
or history of a particular (; ontilpactor , call the M �D
innesota � Depa►-tmen lt of L< the laboicensinor
atid ( ndust�yaCon structionr
C1, des and Licensing Division , at ( 651 ) 2S �4 - S069 . The web site is : 1ttL) ,* //Wqw W .- ( I I i tin v /Cclj . jsp
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