Rental Dwelling Licensing
Affidavit of Non-Rental Dwelling
13065 Orono Parkway
Elk River, MN 55330
763.635.1075
Rentals@ElkRiverMN.gov www.ElkRiverMN.gov/Fire
All rental dwellings in the city must be licensed with the exception of properties that meet the
requirements as outlined in §30-191(b) of the Code of Ordinances. Properties claiming an exception
must have an Affidavit of Non-Rental Dwelling on file with the city, including any required
supplemental documentation.
I, ______________________________ (print full name), being duly sworn and certify under
penalty of perjury:
That I am the legal owner of a certain real property located at _______________________
in Elk River, Minnesota.
I have owned the aforementioned addressed property for ______ years.
That I am aware of the City of Elk River ordinance pertaining to the licensing of rental
dwellings (Chapter 30, Article II).
That the aforementioned addressed property meets the exception requirements as outlined
in §30-191(b) for the follow reason(s):
The property is licensed as a Nursing Home or Boarding Care home by the State of
Minnesota Department of Health shall be exempt from the license required under
this Article. This exception shall not apply if no services are provided to the
Tenants, or the services are incidental to, or independent of, the landlord/Tenant
relationship. Notwithstanding the licensure requirements of such facilities, said
facilities must register with the city.
State licensed residential facilities. Notwithstanding the licensure requirements of
such facilities, said facilities must register with the City.
A single family dwelling or a dwelling unit in a duplex occupied by the Owner for a
minimum of six (6) consecutive months per calendar year.
A residential property owned by a 'snowbird' where the property is rented to another
person for a period of less than 120 consecutive days while the Owner is residing out
of the State of Minnesota. The Owner must occupy the property during the
remainder of the year.
A single family residential property that has been sold on a contract for deed or has
been sold as "rent to own" so long as the purchaser occupies the property and the
sale document used to memorialize the sale is in the form of a uniform conveyancing
blank or is recorded with the Sherburne County Recorder's office. Note: a copy is
shall be provided with this Affidavit.
blank or is recorded with the Sherburne County Recorder's office. Note: a copy is
shall be provided with this Affidavit.
A single family residential property that is occupied by the Owner and two or fewer
Tenants where the Owner and the Tenants share all living space within the
dwelling.
Single family residential property that is owned by a member of the armed services
who is on active duty and the property is rented to another person during the time of
active duty. The Owner shall provide the City with a copy of the Owner's
military orders, and must occupy the property when not on active duty as the
Owner's primary residence.
In the witness whereof, I certify under penalty of perjury under Minnesota law that I know the
contents of this affidavit signed by me and that the statements are true and correct. I further
acknowledge that if, in the future, the use of this property changes to that of an occupied rental
dwelling in which an exception does not apply, I will license this property in accordance with the
Code of Ordinances of the City of Elk River.
Name of owner: _________________________________ (clearly print name)
Street Address: _________________________________
City, State, and ZIP: _________________________________
Phone Number: _________________________________
Signature: _________________________________
STATE OF MINNESOTA
COUNTY OF _______________________________
This instrument was acknowledged before me on _____________ day of __________________,
20________ by _________________________________.
Notary Public: ______________________________
Printed Name: _________________________________
My Commission Expires: ____________________
OFFICE USE ONLY
Date Received: ____________________
Status: Accepted Rejected
Phoenix ID: _____________
Reason: ______________________________
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