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Minnesota Department of Labor and Industry Licensing and Certification Services <br /> Construction Codes and Licensing Uivision Phone: 651.284.5034 <br /> 443 Lafayette Road N Email: DLI.License@state.mn.us <br /> Saint Paul,MN 55155 Webslte: www.dli.mn.gov/ccld.asp <br /> NOTICES � <br /> NOT TRANSFERABLE <br /> CHANGE YOUR BUSINESS STRUCTURE THOMAS BREN HOMES INC <br /> SUBMIT A NEW APPLICATION FOR NEW ENTITY 2073 W WAYZATA BLVD STE 50 <br /> RENEW OR REPLACE INSURANCE POLICY LONG LAKE, MN 55356 <br /> SUBMIT NEW CERTIFICATE OF INSURANCE <br /> ' Nt�►TIFY THE DEPARTMEMT OF/k CHANG�IN YOUR BUSI�IES�. <br /> Failvr�to da so,'subje��s you to administrative�penalties t�up to�1b,0U0.' <br /> 15-Day Notice Requirement—Forms available onlin�i www.dli.mn.aov/CCLD%LicU�date.aso <br /> • Change in business'physical address,m.ai#iog address,pir�sne number,or email address <br /> • Change in control,<qwners,o##i�ers,dn'�ctats,tnemi�rs,;partners <br /> • Change in business`#egr�l';narr�andlor a�umed nam� : <br /> • Loss of or change in dUALIFYCNG BUILD�R <br /> • Char�ge in.;general li�bility insurance or workers'compensativrt.insurancecoverage <br /> Immediate!Natice Requ�r�m�nt—Notification to DLI in writing <br /> • Judgment Debtor .;<A licens�d contractor has 15 days to prt�vide'written!nOti�e of the finding that it is found to be a judgment <br /> _; <br /> debtor based upon conduct7equiring licensure. , <br /> • Bankruotcv Petition Fii�t9;>:;A Iic�I�sQd conttaatq�:h�s 1.5 d�ys to provide written notice that it filed a petiti:on for bankruptcy. <br /> • Conviction Notice.;;:A fice�nsezC contraotflr'has 1 tI<'days tt�;,provide written notice that it has been iuund guiliy of a f�lorty,grnss' r <br /> misdemeanor, m[sdeme�nor 'or .�ny ,;et�rti��arabl� tiffense related to the license, inclu�#ing �onrr�ctions at fraud, <br /> misrepresentation,rnisuse of ft�nii�,theff,:criminal sexual conduct, assault, burglary,conversion�i f�nds, or tlteft of pr:oceeds <br /> in this or any other state or any other United States jurisdiction. <br /> Yf�UA C�RTIFICA7'�15���.4JW THE PERFORATION. ; SH�IIf;C�t�71�lCA'I'�;:WH�N OBTAINING PERMITS. <br /> _ _ _ _ ____ . __ __. _ ___ __ ___ _ _ __ _ _. <br /> _ _ _ __ __ _ <br /> � n�n�vN�saTnngnnrn'�er�t,s� ; �����.��TIAL BLDG CONTRA�7C�R <br /> � <br /> LABOR & IF�IDUSTRY : <br /> ConsVuctlon Codes and Li�en5itig�nri�km:; L�censing and Certification Services 443 Lafayette fiijad�+t St:;Paul,MN"�5155 <br /> Website: www.dli.mn.aovl�ct8 aso ' - Erriail: dif.licenseCc�state.mn.us PriOne: 651.284'.8034 ` <br /> - This<is to certify khat the certificabe holder is licensed as a RESIDENTIAL BUILDING C.QN:TRACT�I�,in the state of Minnesota and is in <br /> com�lianc.e w:ith Miniiesota�btutes 326B.805,and may build residential reat est�te,cat�tract or:offer to cc�ntraet wifh an owner to build <br /> resi�enrial reai estate,'and contract or offer to contract with an owner to im�rove ex�sting residenfial real estate,provuied the <br /> responsible i�tdividual is at al]times a QUALIFI'ING BUILDER and the certifiCate ho�cl�e znain#ain�compliance wl`..th the required general <br /> liability inswance,and workers'compensation laws. <br /> License : RESIDENI'IAL:BL�C�:CONTI�ACTE�R � <br /> l.ic Number : BC1281:44 TH�MA�BR�N HbMES 1NC � ` <br /> Effective Date : 04/01/2012 ;;2(�7�.:�N�I�IAYZ�ITA BL�'Q:STE 50 � ' <br /> Expiration Date : 03/31/2014 LONG LAKE,MN 5535� � <br /> T <br /> V��31FY U!�-�'f�DATE STA7kJS,BOND,AND INSURANCE INFO ATwww.dll„�„n�.;n.novlccf,�iLiC'�erlf�,es� (ENTER NUMBER). <br />