HomeMy WebLinkAbout4.13.23 Letter of non-payment 4.25.23 Permit Application 17JI
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MUTLDING PERt'VII=ICA I: PROPERTY O NN'ER
I, Tic ,JrsC�/�G J�t_Ac . understand that the State of Minnesota requires
that all residential building contractors, remodelers and roofers obtain a state license
unless they qualify for a specific exemption from the licens-ing requirements This license
requirement applies to owners of residential real estate who build or improve such
property for purposes of speculation or resale.
BY signzng U- s document, I attest to the fact that I arr:
use a d-M not bui Iding or improving this.}souse for ih�ProPUI y�this house for my own
claim to be ex�; pt from the state Uce�nsing requirements bt,-cause I amOse of elLrin it I hereby
of building or remodeling on speculation or for resale and that the house use 1 in the
h�b i��ss
applying for this permit, 1=-'led at 7 S7"j
only residential structure I hive built or improve
d in the past 24 u:untrs. 1 also
acknowledge that because I do not have; a state license, I forfeit any uiechsltie's lien
tights to which I may otherwise have been entitled tinder Minn. Stat. §514.01.
Furthermore, I acknowledge that I may be hiring independent contactors to perforn
certain aspects of the corls-trtiction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minn esota. I
understand that unlicensed re contracting, remodeling, and/or roofing activity is a
misdemeanor under Minn. Stat. §326B.082, subd. 16 and can also result in a fine of up to
$10,000. I further state that I understand that the filing o f a false statement with The Cites; of Fridley may also result in criminal prosecution and/or civil penalties
to applicable city ordinances and/or state statutes.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to The City of Fridley for compliance will
all applicable building codes and city ordinances vith wo ein ormed on this
property.
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U N �C FtFFLF O �'
Z�c ucl ,� �c r � , jlnature of Property Owner
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Dale
For questions or information on contractor licensin;, or to check the licensing status zral enforcement
hi eery of., particular contractor, call the Minnesota Department of Labor and Industry, Construction
Codes and Licensing f);►,s;on. at c651}"l&1-;Obi 1;1C ueb sits is ht_ to I/www dli,mn.¢ovo -cl. d.;Ls�