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Building Permit Number <br /> BUILDING PERMIT APPLICANT: PROPERTY OWNER <br /> I understand that the State of Minnesota requires that all residential building contractors,remodelers and roofers obtain a state <br /> license unless they qualify for a specific exemption from the licensing requirements. By signing this document,I attest to the fact <br /> that I am the property owner and I am performing this work myself. I hereby claim to be exempt from the state licensing <br /> requirements because I am not in the business of building on speculation or for resale and that the house for which I am applying <br /> for this permit,located at: <br /> Address <br /> This is the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not <br /> have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minnesota Statute <br /> 514.01. <br /> Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or <br /> improvement of this house, and I understand that some of these contractors may be required to be licensed by the State of <br /> Minnesota (or the City of Ramsey). I understand that unlicensed residential contracting;remodeling, and/or roofing activity is a <br /> misdemeanor under Minnesota Statutes 326B.845 Sub. Div. 1 and 2, and that I would forfeit my rights to reimbursement from <br /> the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. <br /> I also acknowledge that by signing for the permit,I am solely and personally responsible for any violations of the state building <br /> code and/or city ordinance in connection with the work performed on this property. <br /> Signature of Property Owner <br /> Date <br /> To determine whether a particular contractor is required to be licensed, or to check on licensing status of individual <br /> contractors, please call the Minnesota Department of Labor And Industry, Enforcement Division, at 651-284-5065, or <br /> toll-free at 1-800-657-3944 or the City of Ramsey at (763) 433-9850. You can also check for licensure at <br /> https://secure.doli.state.mn.us/lookup/licensing.aspx <br /> *********************************FOR OFFICE USE ONLY********************************* <br /> Engineering Date Construction Type <br /> Planning Date Occupancy Classification <br /> Building Date Special Conditions <br /> Septic Date Environmental <br /> Fire Date Total <br /> It is our mission to work together to responsibly grow our community,and to provide quality,cost-effective and efficient government services. <br />