| 1. Address of rental property: |
| 2. What is the Parcel number for
this property? |
| 3. List the complete name,
address and phone number of each owner/partner/corporate officer
of the above listed rental property: |
|
|
| 4. List the complete name,
address and phone number of the caretaker/manager for above listed
rental property: (Please note: If the owner lives
out of Perham or Ottertail County, there must be a designated
property manager/caretaker locally to contact in case of
emergency, etc.) |
|
| 5. How many apartments with
separate cooking facilities are in this building? |
| 6. Type of dwelling. Please
note: Owner occupied with a sleeping room or apartment is
considered a two-family dwelling unit. (Check One) One
Family Two
Family Multiple
Family Mobile
Home |
| 7. How many rooms in this
building are sleeping rooms only? (Please note: A
sleeping room is rented as a single room with no cooking
facilities.) |
| 8. How many basement-sleeping
rooms are in this building? |
| 9. How many basement apartments
are in this building? |
| 10. How many bedrooms are in
each unit? 1
Bedroom 2
Bedroom 3
or More Bedrooms |
| 11. Is this building Owner
occupied? Yes
No |
12. Is this rental unit a mobile
home? Yes
No
a. Year mobile home was manufactured:
b. Make of mobile home:
c. Model of mobile home:
d. Serial number of mobile home: |
| 13. Is off-street parking
provided: Yes
No
Number of spaces: |
|
NOTICE TO
APPLICANTS: |
- The City of Perham Emergency Services
should be notified within five (5) business days of any
transfer of legal control such as a contract for deed, lease
to buy, etc., as well as change in local caretaker/manager for
each rental property.
- Please see the Perham City Hall for a
copy of Ordinance #213 regarding minimum building standards,
registration and inspection of rental housing unites. Owners,
agents and managers should become familiar with its
provisions.
- Failure to register rental property
within thirty (30) days after the due date may result in the
CIty of Perham taking action against you.
- A rental registration certificate will be
mailed to you at a later date to be posted in a visible
location in the rental dwelling at all times.
- You may also obtain from City Hall a
description of the Crime Free Housing Program, that is part of
the Community Policing Program. This is a voluntary program
and is not required. Any questions in regards to this program
should be directed to the Emergency Services Building.
|
| The undersigned hereby applies
for a rental dwelling registration as required by City Code and
attests that the subject premises will be operated and maintained according
to the City's requirements for rental property and
understand they are subject to applicable sanctions and penalties
if not complied to. The undersigned further agrees that the
subject premises may be inspected by the compliance official as
provided in Ordinance #213. The applicant further certifies that
all statements and facts in this application are true and
authorizes the City of Perham to investigate any or all statements
of facts contained herein; acknowledge that the misrepresentation
or the omission of facts called for will be just cause for the
revocation/suspension of this registration. |
| Owner/Resident
Agent initial here: First name initial
Middle name initial
Last name initial |
| Date: |
