Vacant Building Application all Received Stamp
.A\Ibiertvillie
Small Tbui;;n Living.Big City Life.
Vacant Building Registration Application
Date: Address of Property:
PID: Legal: Lot: Block: Subdivision:
OWNER INFORMATION
Name
First Middle Last
Owner's Address
(Not Property Address) Street City State Zip
Daytime Phone Cell Phone:
E-mail Address:
LIEN HOLDERS INFORMATION
Name:
Address:
Street City State Zip
Phone Number: Contact Person:
Date Property Vacant: Expected Time to be Vacant:
REALTOR AND OR PROPERTY MANAGEMENT INFORMATION
Business Name:
Address:
Street City State Zip
Phone Number: Contact Person:
E-mail Address:
*If property is sold or transferred the City of Albertville must be notified and any required inspections must be completed
CITY OF ALBERTVILLE 5959 MAIN AVENUE NE 763.497.3384 x103
BUILDING DEPARTMENT ALBERTVILLE,MN 55301 WWW.CLALBERTVILLE.MN.US
1
$100.00 Registration Fee Must Accompany Application
Make Checks Payable to: The City of Albertville
Mail to: P.O. Box 9
Albertville, MN 55301 Received Stamp
Attn: Vacant Building Registration
UTILITES
Utility Connection Status:
Gas ❑ On ❑ Off Date: Electricity ❑ On ❑ Off Date:
Water ❑ On ❑ Off Date: Comments:
Office Use Only:
Property Inspection: By:
Finance:
Fee Paid On: Fee Paid By:
Paid: Ck,Cash,CC Fee Assessed: Date:
Comments:
Copied to:
Wright County Sheriff's Department: Bank/Owner:
Finance Director: City Attorney:
House File: Other:
CITY OF ALBERTVILLE 5959 MAIN AVENUE NE 763.497.3384 x103
BUILDING DEPARTMENT ALBERTVILLE,MN 55301 WWW.CI.ALBERTVILLE.MN.US
2