CITY OF COLUMBIA HEIGHTS RENTAL HOUSING LICENSE APPLICATION by rosieherman

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									            CITY OF COLUMBIA HEIGHTS
            RENTAL HOUSING LICENSE APPLICATION

     Application Instructions:             STEP ONE:
     Section 1:

        If you have a property management company or your corporation owns and operates the property,
        fill that company or corporation information in section one (1). Please be sure to check the CORP./CO./
        PROP MGMT CO. box and complete section two (2).
        If you are the building owner, check the "BUILDING OWNER" box and fill in your information in section
        one (1). You can skip section two (2).

        Please note that if you have checked the "CORP./CO./PROP MGMT CO." box in
        section one (1) we must have a contact name and address and phone numbers in section two(2).

     Section 2:
        If you provided a comany or corporation name in section one (1), you must provide us the name,
        address and phone numbers of one of the company or corporation officers in section two (2).
        No P.O. boxes are allowed for the address section. The application will not be processed if this section
        is not filled out properly and all requested information is not provided.

     Section 3:
        Fill this section out only if you have purchased the property on a contract for deed. If you have
        purchased the property on a contract for deed, provide the deed holder information in this section.

     Section 4:
        In the first box enter the number of rental units that are in the building. If the building is a single
        family home, enter 1. Also enter the number of units and their corresponding number of bedrooms.

        Example: If the building has four (4) rental units and one unit is a studio and two of the units have two
        bedrooms and the last unit has three bedrooms, section four would look like this:

 4     Property Information:                                                     How many bedrooms-units are in the building***

Number of rental units:    # of studio units # of 1 bedroom units # of 2 bedroom units # of 3 bedroom units # of 4 bedroom units

       4                         1                                      2                     1

Enter the # rental units in the building


        Please sign and date your application. Make your check payable to the City of Columbia Heights.
        Your application and check can be returned to:

               Columbia Heights Fire Department
               Inspection Office
               555 Mill Street, N.E. Columbia Heights, MN 55421

 STEP TWO:
        Call 763-706-3656 and schedule a interior/exterior inspection of the property.


     * Denotes required information. This information must be provided to process application.
             CITY OF COLUMBIA HEIGHTS
             RENTAL HOUSING LICENSE - NEW RENTAL APPLICATION
             Columbia Heights Fire Department Inspection Office
             555 Mill Street N.E. * 763-706-3656 * fireinspections@ci.columbia-heights.mn.us

 RENTAL PROPERTY ADDRESS:
 RENTAL LICENSE FEE:                                                                             PERMIT NUMBER:
 THE RENTAL FEE COVERS A ONE YEAR PERIOD                                               LICENSE ISSUED MONTH:

1          BUILDING OWNER              CORP./CO./PROPERTY MGMT CO.                                (Please check the appropriate box)

Building Owner OR Property Management/Co. Name:                                                Cell Phone or Pager No:
                                                                *Home:



                                                                *Work:                         *Bldg Owner Date of Birth OR D/L No.:

 Building Owner OR Property Management/Co. Address:

                                                               E-Mail Address (optional):


                                                               *Bldg Owner Emergency Contact Name/Number:
 * Denotes Required Information and Must be
   Provided to Process Application

 2   Responsible Person - Information of Corporation or Company President, Manager, CEO.

Responsible Person Name:
                                                               *Resp Person Home Phone:        Resp Person Cell or Pager No:



                                                               *Resp Person Work Phone:       *Resp Person Date of Birth OR D/L No.:

Responsible Person Address:

                                                               E-Mail Address (optional):


(No P.O. Boxes allowed here)
                                                               *Responsible Person Emergency Contact Name/Number:
* Denotes Required Information and Must be
  Provided to Process Application

3     Name and address of Contract of Deed holder. (Use only if you have bought the property on a contract for deed)

Deed Holder Name:                                                                              *Emergency Contact Name/Number:
                                                               *Home:



                                                               *Work:                          *Deed Holder Date of Birth OR D/L No.:

Deed Holder Address:

                                                                Cell Phone:                    E-Mail Address (optional):




4     Property Information:                                                         How many bedrooms-units are in the building***

Number of rental units:   # of studio units # of 1 bedroom units # of 2 bedroom units # of 3 bedroom units # of 4 bedroom units



 Enter the # rental units in the building




     Licensee/Applicant Signature                            Print Licensee/Applicant                             Date

								
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