Vacant Rental Improvement Program Initial Intake Form

Property owner(s) name *

Address including zip code *

Phone *

Email *

Number of vacant units? (building must be 5 units or less) *

Residential, Commercial or Both? *

Owner occupied? *

Are property taxes current (City & County)? *

If not, please explain:

Are water bills current? *

If not, please explain:

Are user fees (garbage) current? *

If not, please explain:

Do you have homeowner’s insurance? *

If not, please explain:

Are you currently working with a general contractor, architect, engineer? *

If yes, please list:

Is the property currently in housing court or does it have code violations? *

If yes, please list:

Provide a brief description of the work that needs to be done: