Fillable Request Inspection Application - $200.00 fee (City of Duluth)

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Request Inspection Application - $200.00 fee (City of Duluth)

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The Request Inspection Application - $200.00 fee (City of Duluth) form is 1 page long and contains:

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File type: PDF

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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/
Request Inspection Application - $200.00 fee
Property Address:
Type of Property:
Single Family Duplex Multi-Dwelling: specify # of units:________
Applicant Information:
Name(s):____________________________________________________________________________
Address:____________________________________________________________________________
Cell Phone:_____________________________ Alternate Phone:_______________________________
Email Address:________________________________________________________________________
Agent/Representative Information (if different than above):
Name(s):____________________________________________________________________________
Address:____________________________________________________________________________
Cell Phone:_____________________________ Alternate Phone:_______________________________
Email Address:________________________________________________________________________
Owner/Agent Signature:_____________________________________ Date:_________________________
*NOTICE: If the property is converted into a rental within 12 months of the inspection, the Request
Inspection fee can be used to reduce the cost of applying for the rental license.
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Request Inspection Application - $200.00 fee (City of Duluth)

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Completed 3 August 2020

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