Life Safety Division City of Duluth Fire Department
615 West First Street • Duluth, MN 55802
Phone: 218-730-4380 • Fax: 218-730-5902
Email: lifesafety@duluthmn.gov • Website: www.duluthmn.gov/fire/
Rental License Transfer Application - $25.00 fee
Rental Property Address:
Type of Property:
Single Family Duplex Multi-Dwelling: specify # of units:________
Owner Information:
Name(s):____________________________________________________________________________
Address:____________________________________________________________________________
Cell Phone:_____________________________ Alternate Phone:_______________________________
Email Address:________________________________________________________________________
Manager Information (A local manager is required if owner does not live within 25 miles):
Name(s):____________________________________________________________________________
Address:____________________________________________________________________________
Cell Phone:_____________________________ Alternate Phone:_______________________________
Email Address:________________________________________________________________________
I hereby acknowledge that I have completed this application and state that the information contained
therein is correct:
Owner/Manager Signature:_____________________________________ Date:_________________________
*NOTICE: The information provided in this application is of public record.
We are unable to transfer a rental license without this completed application & the $25.00 fee.
Return completed application to the Life Safety address listed above.
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signature
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