Registration Fee $25.00

APPLICATION FOR RENTAL REGISTRATION
City of Detroit Lakes
1025 Roosevelt Avenue, P.O. Box 647
Detroit Lakes, MN 56502-0647
218-847-5658, Fax 218-847-8969

1. Address of Rental Property:____________________________________

   _______________________________________________________________

2. Parcel number of rental property:______________________________

   _______________________________________________________________

3. Name, Address, Phone and FAX No. (if applicable) of each
   owner/partner/corporate office of above rental property.

  _______________________________________________________________

  _______________________________________________________________

4. Name, Address, Phone and FAX No. (if applicable) of caretaker/
   manager for above rental property: (Please note: If the owner
   lives more than 30 miles from the City of Detroit Lakes, there
   must be a designated property manager/caretaker locally to
   contact in case of emergency, etc.)

   _______________________________________________________________

   _______________________________________________________________

5. Name, Address, Phone and FAX No. (if applicable) of person
   authorized to make or order repairs or services (if different
   than owner or property manager).

   _______________________________________________________________

   _______________________________________________________________

6. Type of dwelling: (Example: Owner occupied with a sleeping room
   is considered a two-family dwelling unit according to our
   office.) [__] One Family   [__] Two Family
   [__] Multiple Family   [__] Mobile Home
   (Please note: if the rental unit is a mobile home outside a
   mobile home park, please include the year, make, model and
   serial number of trailer)

   _______________________________________________________________

7. Total number of rental units at above listed rental property:

   _______________________________________________________________

8. How many sleeping rooms are in this rental dwelling:___________

9. How many apartments/sleeping rooms are located in the basement
   of the rental property?
   [___] Basement Apartments   [___] Basement Sleeping Rooms

10. Is off-street parking provided? [__] Yes  [__] No
    Number of spaces: [___]

11. NOTICE TO APPLICANTS:
    A. The City Administrator must be notified, in writing, within
       five (5) business days of any transfer of legal control.
    B. Copies of the Dwelling Maintenance Code, Chapter 1002, of
       the City Code, are available from the City of Detroit Lakes.
       Owners, agents and managers should become familiar with its
       provisions.
    C. Failure to register rental property within (30) days after
       the due date will result in a late charge, which will be
       according to the Annual Registration Late Fee Schedule.

12. APPLICATION
The undersigned hereby applies for a rental dwelling registration
as required by City Code, acknowledges that the provisions of the
Rental Registration Program have been reviewed and attests that the
subject premises will be operated and maintained according to the
requirements contained therein, subject to applicable sanctions
and penalties. The undersigned further agrees that the subject
premises may be inspected by the compliance official. The applicant
further certifies that all statements and facts in this
application are true and authorizes the City of Detroit Lakes to
investigate any or all statements or facts contained herein;
acknowledging that the misrepresentation or the omission of facts
called for will be just course for the disqualification or repeal
of this registration.

SIGNATURE ________________________________ Date __________________
		Owner/Resident Agent