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BUa.n'\.G PERMIT APPLICANT : PROPERTY OWNER
Di iedj om
1, B t a b u h understand that the State of Minnesota
that all residential building contractors, remodelers and roofers obtain a state license
ures
unless they qualify for a specific exemption from the licensing requirements. This license
requirement applies to owners of residential real estate who build or improve such
Property for purposes of speculation or resale.
By signing this document, I attest to the fact that I am improving thus house for my own
use and am not building or improving this house for the
claim to be exempt from the state li purpose of reseiling it. I hereby
eensing requirements because I am not in the business
of building or remodeling on speculatior. car fn- .rc�lt - ,A 14 ,. ,�..,
applying for this pe�'it, 1°ca;� 5 2 4 S C a p t o 1 St r e e�t` �V E
is the only residential structure I rave oturt or w.
. the past 24 -months. I also
acknowledge that because I do not have a state license, I forfeit any mechanic's lien
rights to which I may otherwise have beer. 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 contractors 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 Minn. Stat. §326B.082, subd. 16 and can also result in a fine of up to
S 10,000. 1 further state that I understand that the Fling of a false statement with
The Citv 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 b!!5iEi
li ractor for
this project, I alone will be responsible to The Ci will
all applicable building codes and city ordinances on this
property.
Signature of Property O►w ner
Date
For questions or information on coat wtor licensing, or to check the licensing status and enforcement
history of a particular contractor,call the Minnesota Department of Labor artd Industry, Construction
Codes and Licensing Division, at(651)234-5069 The web site is httnJ/www dli mn &IMLCLr4,—n