HomeMy WebLinkAbout1501 Camelot - Property Owner Form - Fridley tad
EIIILDINCT PERMIT APPLICANT: PROPERTY Q N -R
I' N�C,tL 4A)04�-�PSOAJ 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 ofresidential real estate who build or improve such
property for purposes of speculation or resale.
By signing this document, I attest to the Tact that I any improving this Iaouse for my o vsm use and am.not building or improving this house for d 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 J.,S:o I CAAAs.Iet- AXIS
is the only residential structure I have built or Improved in the past 2 ,mothss�l`'
acknowledge that because I do not have a state license, I forfeiany mechanic's lien
rights to which I may otherwise have been 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
$10,000. I further state that I understand that the filing of a false statement with
1ht!:!bL2ffrjAIa 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.
Sign tr f Pr•r�,,/_ � d�wzzer
For questions or information on contractor licensing,or to cheel<the licensing status and enforcemer;t
history of a particular contractor, call the Minnesota Departmerit of Labor and Industry, Corstruction
Codes and Licensing Division, at(651)284-5069.The web site is: hL L)..I