HomeMy WebLinkAboutScanned_from_a_Lexmark_Multifunction_Product05-30-2023-175424 CI T'Y�,�•
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BUILDING PERMIT APPLICANT : PR.QPERTY C7jili\fE-R
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 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 this house for my ow;i
use and a.n not building or improving this house for the purpose of reselling it.I hereby
claim to be exempt from t„e state ':.icensing regairements because I am not in the business
of building or remodeling on speculation or for resale and that the house for which I aun
applying for this permit, located at
is the only residential structure I hav�lt improved inthe a�24 rnon acknowledge that because I do not have a state license, I forfeit any mechanic's lien
rights to which I may otherwise have been entitled under Mina.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 rooting activity is a
misdemeanor under Minn. Stat. §.:26B.032,subd. 16 and can also result in a fine of up to
I0,000. I further state that I understand that the filing of false statement with
'I'Iue City of F7•idIev 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 %k iil
-dI applicable building codes and city ordinances with the work being preformed oil this
Property.
Signature of Property f3cvner
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For questions or information on contractor licensing,or to et;eck the licensing status and Info-cement
history uf:t DK niculu contractor,call the f4f inrlcsota Depattrncyt of Labo--Lid fndustry,Constru�'tior
Caries ar.�{l.icrnsir-g Division,,�;{65 f� ea_5069 The web site is: figUI/m,w A--.dfi. .asp
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