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"==-r-:_v-��--.:- .s.:_.'-..��:��c-.l nzz.-�_:-_,...a.r�v:.•..:.-�_r:r_xar� ..t_- ---<<��.�--.R-- - - - - - - _L <br /> APPLICATION ONLY <br /> CERTIFICATE OF HOUSING MAINTENANCE COMPLIANCE <br /> I HEREBY REQUEST AN INSPECTION FOR A CERTIFICATE OF HOUSING <br /> MAINTENANCE COMPLIANCE.-TO MEET $T.;LOUIS: PARK-HOUSING COMPLIANCE <br /> STANDARDS. THIS RESIDENCE;IN THE CITY OF ST. LOUIS PARK,IS.A SINGLE/DOUBLE . <br /> FAMILY UNIT. <br /> Address to be Inspected: <br /> Present Owner's Name: Phone No. <br /> Address(if differs from above): City: Zip: <br /> Realtor/Representative: Phone No. ' <br /> Address: City: Zip: <br /> I certify that I am the owner/agent and that the statements contained herein are true and accurate <br /> in all respects to the best of my knowledge and belief. <br /> Signature of Applicant: Date: <br /> This Certificate of Housing Maintenance Compliance should be sent to: <br /> (if differs from above address) <br /> Name: Address: <br /> FOR OFFICE USE ONLY <br /> Inspection Date:_ Inspection Time: <br /> 13 Sale of Owner Occupied Property I70ecupancy Change of Rental Property <br /> ❑Sale of Rental Property <br /> PAID TO CITY OF ST.LOUIS PARK: <br /> Date: <br /> Recelpt/CeAfficate N% <br /> Fee: <br /> Check No. /Cash <br /> Code:3239 <br />