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2015_0914_CCpacket
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2015_0914_CCpacket
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������, <br />_,�►,'1. 7 � J \ e_ / J / <br />Community Developmeut Department <br />Rental License Program <br />�'� Civic Center Drive, Roseville, MN 55113 <br />_ ue - 651-792-7013 FAX — 65l -792-7070 <br />rentallicense@cityofroseville.com <br />www.cityofi•oseville.com <br />OFPICE USE ONLY <br />License #:���s ��`��� <br />Fee: -„�" ` rJ �//J <br />Receipt #: $✓G /� <br />Date #: r� "� <br />2015 Rental License Application <br />Multifamily Buildings with Five or More Units <br />RENEWAL <br />Section 1. Rental Property Information (please fill out a. separate application per building address) <br />Rental Property Address (street address of building and ZIP): <br />204 Nort �I�����rons Blvd, Roseville MN 55113-6932 <br />Efficiency Unit #s: 1 Bedroom Unit #s: �\ 2 Bedroom Unit #s: 3 Bedroom Unit #s: 4 Bedroom Unit #s: <br />0 <br /># <br />� �� ��r�� <br />,�� �� <br />Baths <br />Sq. Ft./Bdim # � � � Baths <br />Sq. Ft./Bdinl <br />�� <br />� �_ Baths <br />� Sq. Ft./Bdrms <br />0 <br /># Baths I # Baths <br />Sq. Ft.Bdtn�s Sq. Ft./Bdrnls <br />Section 2. Rental Property Owner Information <br />Name of Owner(s): ' - / y � � . � ( Tax ID#: <br />( � <br />Owner's Street Address: <br />� �ti�P� _ �t��r.._ <br />e <br />City/State: <br />, •: <br />Phone #l: Phone #2: En,a�]: � <br />� .`r <br />_ t . , r, _ <br />C�wnership Info: � <br />❑ Corporation � Partnership � Sole Proprietorslvp Q Other Business Entity <br />Section 3. Local Agent Responsible for Maintenance and Management of this Rental Property <br />Name of Local Agent: <br />Perennial Management <br />Agent's Street Address (cannot be a PO.Box): <br />1360 Energy park Drive #300 <br />Phone: (Emergency-24 hour co�rtact) Phone #2: ` <br />651-644-9600 <br />City/State: <br />St. Paul, MN 55108 <br />Email: <br />dnelson@perennialmgmt.com <br />kdarrington(a�.perennialmgmt.co <br />
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