For Tenant/Landlord Rights & Responsibilities Refer to: http://www.ag.state.mn.us/Brochures/pubLandlordTenants.pdf
1685 CROSSTOWN BOULEVARD NW, ANDOVER, MINNESOTA 55304 (763) 755-8700 • FAX (763) 755-8923 • WWW.ANDOVERMN.GOV
Please List Each Rental Dwellng Unit Street Address Below
OWNER / MANAGEMENT INFORMATION
Individual/s Partnership Corporation
Owner / Responsible Person Name: ___________________________________________________________
Business Name (If Applicable): _________________________________________________________________
Street Address: ___________________________________________________________________________
City: _______________________ County: _______________ State: ______ Zip Code: _____________
Daytime / Business Phone: ________________________ Residence Phone: ________________________
Cell Phone: ________________________ E-mail Address: _____________________________________
LICENSE TYPE New Two -Year Renewal
MULTIFAMILY RENTAL LICENSE TWO (2) YEAR LICENSE FEE CALCULATION
A separate license is required for each living unit in a building. Please indicate total number of units below.
____________________
$75.00 per licensed unit
(except owner occupied)
$ ________________
Note: A re-inspection fee of $50.00 may be charged separately for each valid complaint.
I hereby certify that the above information is true and correct. I understand all mailings from the City of Andover will be mailed to address specified above. I will
notify the City within five (5) business days of any change of required information required. I hereby apply for a multifamily rental license pursuant to City codes.
___________________________________________________________________________ __________________________________________________________
Signature Date
MULTIFAMILY RENTAL LICENSE APPLICATION
FOR RENTAL
DWELLINGS
WITH TWO OR
MORE LIVING
UNITS
