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Home My WebLink AboutBuilding Applicant Property Owner Form t S c FR.C;r I=_ oenan �e ,understand that the State of 1\ilinnesota require that residual building contractors, remdelers and roofers obtain as ate license they quallt' for a specific exemption from the license-: requuirement applies to ov,�zers 'of residendal real esttite vvho build o requirements improve This license sLcja ;Property for pu-Toses of speculation or resale. By signing this document,I attest to the f use and am not building or act that I am improving this house for my own improving this house for the g it I hereby claim to be exempt from the state licensing requirements because i am nose of oon the bus-mess of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, located at LO,1 c ksc,�, .5� IjC, FI;clle . �f1 t 3 7- The .IS only residential structure I have built or improved in the I al acknowledge that because I do not have a state license, I forfeit anymecohanic,s lien Tights 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 eeriain aspects of the construuctiou or:rnproverrent of this house and I uunders'uard that -some of these contractors May be required to be licensed by the State of MilZrresota I understand that unlicensed residential contracting,remodeling misdemeanor uncler Ni'i � � �� an VOr roofing activity is a ,nn. Stat §3 0$.082, subd_ 16 and can also result in a fine of up to �I0;000. I l urther state that I understand that the filing of a false stater with Tie Q of Fridley may also resu it in criminal Prosecuton an&or ci�ne::t l penalties to applicable city ordinances and/or state statutes. i have also been infb-need and acknowledge that by listing myself as the contractor for :his project,I alone will be responsible ro The City of Fridley—.for compliance will all applicable building codes and city Ordinances with the wort: ein property- Signature g preformed on this Signature of Property Amer G&" Date For questions or information on contractor licensing, or to check the licensing status and enforcement History of a particular contractor,call the Minnesota Department of Labor and industry,Construction Codes and Licensing Division,at i"551)284-5059.The web site is: uafCL3t� y