HomeMy WebLinkAbout3894_001 Cr
FRIDYL%
EUII-DINCT PERMIT APPLICANT: PROPERTY OWNER
I, greg massey
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 aril improving this house for my own
use and azri not building or improving this house for the purpose of reselling it I hereby
claim to be exempt from the state licensing requirements because I am not in the business
of building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, located at 5941 6th St NE
is the only residential structure I have built or improved in the past 24 mariths. I also
acknowledge that because I do not have a state license, I forfeit any mechanic's lien
Nights to which I may otherwise have been entitled under A/Er i. 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 Minneso I
.082
understan ta.
misdemeanor under Minn. Star. §32GB d that unlicensed residential contracting, remodeling, and/or roofing activity is a
,subd. 16 and can also result in a fine of up to
10,000. I further state that I understand that the filing of a false statement with
The City of FA•idlev 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 with the work being preformed on this
property.
SigrAa�ofperty owtzer — -
Date — ——
For 1j;iestions or irformation on contractor licensing; or to check the licensing status and enforcement
history of a part contractor, call the Minnesota Department of tabor and Industry,Construction
Codes and Licensing Division, at(65 i) :3=1_5069. The ,Neb situ is• I qJ)frwww dli.r r�.�. / 'cld,
&uv_C l +--An