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Lin" that
and
�f rooferse of obtaiMinnesota
a atatc license s
ororn an
conuactor�s.mm from the licensing requirements.This license
I• 'u°'' cnua►build n8 i fic cxernption estate who build or improve such
that all res aalio,for a speC o fresidenttal real
unless the)'q owners le.
n�tuiremfcntlau s or'P, lotion or resa im roving this house for I h o�
prup,r,) the fact that 1 sun p of reselling it. I hereby
document"I attc�t to
this house for the purposenot in the business
py sign�n8 thi+docum or imProvin8 uircment-9 because l strn ch I _
uy,.and ant not bu`(ro the state licensing req a and that the houscrfot^wl
claim ry be exemP on speculation or for regal
Of buildinl3 or ne it,l ted at past 24 months. I also
ap�ly,�for this prnnt'•10� 1 have built or improved to the
mechanic's lien
is the only residential structure 514.01.
e that because I do not have nsentitled underfM�ttrt. Su't. §
�JCnotill�-dg otherwise have
rights to Which I may be hiring independent contractors to perform
Furthermore, I acknowledge that I may
-of the construction or improvement of this house and I understand that
art . aspects required to be licensed by the State of Minnesota. 1
some of these contractors may t(' mmodeling, and/or roofing activity is a
understand dial unlicensed residential contracting, .
inn. stet. §326B.082,subd. 16 and can also result with of up to
misdemeanor under'�1 of a false state
sl0.000. 1 further state that I understand that the filing
�City of Fridl may also result to crim
to applicable inal prosecution and/or civil penalties
The lic�ble city ordinances and/or state statutes.
'
�\ n informed and acknowledge that by listing myself as the contractor for
I have also been
this project, I alone will be responsible to The City of Fridley for compliance will
all applicable building codes and city ordinances with the work being preformed on this
property'
Signature of Property Owner
Date
for questions or information on contractor licensin►,, or to check the licensing status and enforcement
history ofa particular contractor, call the Minnesota Department of Labor and Industry, Construction
Codes and Licensing Division, 11(651)284-5069. Tlie web site is: httl2,//www.dli mn g v/ _cldl s+Qn