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BUILDING PERMIT APPLICANT: PROPERTY OWNER <br /> I, l�C�q�Le� l�� �✓1(�-�� , understand that the State of Minnesota requires <br /> that all r sidential building contractors, remodelers and roofers obtain a state license <br /> unless they qualify for a specific exemption from the licensing requirements. This license <br /> requirement applies to owners of residential real estate who build ar improve such <br /> property for purposes of speculation or resale. <br /> By signing this document, I attest�o the fact that I am improving this house far my own <br /> use and am not building or improving this house for the purpose of reselling it. I hereby <br /> claim to be exempt from the state licensing requirements because I am not in the business <br /> of building or remodeling on speculation or for resale and that the house for which I am <br /> applying for this permit, located at � `%%�'' ���;!���.�� � ; �r��c���, � tx,�, Orono, is the first <br /> residential structure I have built or improved in the past 24 months. I also acknowledge <br /> that because I do not have a state license, I forfeit any mechanic's lien rights to which I <br /> may otherwise have been entitled under Minn. Stat. §514.01. <br /> - Furthermore, I acknowledge that I may be hiring independent contractors to perform <br /> certain aspects of the construction or improvement of this house and I understand that <br /> some of these contractors may be required to be licensed by the State of Minnesota. I <br /> understand that unlicensed residential contracting, remodeling, and/or roofing activity is a <br /> misdemeanor under Minn. Stat. §326B.082, subd. 16 and can also result in a fine of up to <br /> $10,000. I further state that I understand that the filing of a false statement with the City <br /> of Orono may also result in criminal prosecution and/or civil penalties pursuant to <br /> applicable city ordinances and/or state statutes. <br /> I have also been informed and acknowledge�hat by listing myself as the contractor for <br /> this project, I alone will be responsible to the City of Orono for compliance with all <br /> applicable building codes and city ordinances in connection with the work being <br /> performed on this property. <br /> � :� <br /> � ��-G� <br /> Name <br /> �l5l/U <br /> Date <br /> For questions or information on contractor licensing, or to check the licensing status and <br /> enforcement history of a particular contractor, call the Minnesota Department of Labor <br /> and Industry, Construction Codes and Licensing Division, at (651) 284-5069. The Web <br /> site is: www.doli.state.mn.us/contractor <br />