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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 Iicensure at <br />https://secure.doli.state.mn.usilookupilicensing.aspx <br />****4"***************************FOR OFFICE USE ONLy********************************* <br />Engineering <br />Planning <br />Building <br />Septic <br />Fire <br />Date <br />Date <br />Date <br />Date <br />Date <br />Construction Type <br />Occupancy Classification <br />Special Conditions <br />Environmental <br />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 />