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DOCSOPEN-MU210-54-1030781.v1-5/30/25 Acknowledgement of Responsibility: It is the responsibility of the owner(s) and/or person acting as an agent for the owner to ensure the information provided is complete and accurate. Owner(s) must comply with city codes and the approved property plan. Failure to comply is a misdemeanor. Unpaid vacant building registration fees may be certified against the property. The vacant building registration process must be completed annually. You will be notified by the City in writing prior to the renewal due date. Vacant building permits will be mailed out to an owner or agent after a property inspection is completed. Please contact the City of Mounds View regarding any change in property status within fifteen (15) days of change. If the owner fails to abate a nuisance under City Code, section 91.042 (F), related to lawn maintenance on the vacant property, after receiving notice from the City to do so, owner consents to allow the City to enter onto the property and abate the nuisance. Costs associated with such nuisance abatement may be certified against the property. For more information on the vacant building ordinance and requirements, please review Sections 91.030-91.046 of the City Code. Applicant Name (Please Print): ___________________________ Applicant Signature:_____________________________________ Date:____________________ Registration Fee, Signed and Completed Application and Property Plan Must be Submitted in Person or Mailed to: City of Mounds View, 2401 Mounds View Boulevard, Mounds View, MN 55112 Missing or incomplete applications will be returned and considered unregistered. For questions regarding the Vacant Registration Application, please contact XX City Use Only Vacant Building Application Approved Yes No By: Property Plan Approved Yes No By: Vacant Building Application Certificate Issued on: By: Staff Notes: DATA PRACTICES INFORMATION: This information is classified as private or nonpublic data: any data that could be used to identify the location or security status of a registered vacant building is considered to be “security data” under Minnesota Statutes section 13.37. You are required by ordinance to provide this information. The information is used for purposes of ordinance enforcement. If you refuse to provide the information, the City will administratively register the property. The classified information is made available only to the owner, registered agent or other person responsible for the maintenance of the property, and to City staff persons involved in ordinance enforcement. The data may become public if enforcement actions are taken under the ordinance, such as nuisance abatement or criminal citation.