Boulder Rental Housing License

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					                                      Rental Housing License Application
                (Please submit a $70.00 fee with application. Make checks payable to “City of Boulder”)

    ____________________________________________________________________________________________________
    Rental Property Address                                   Zip Code             Unit/Apt. #


    Number of Dwelling Units__________________                      Number of rooming units _____________
    (Rooms connected with bathroom and kitchen facilities)          Number of Bedrooms______________________

    Building Type (Check One):

     Single Family Dwelling          Condominium            Apartment Building       Manufactured/Mobile Home

     Duplex       Tri-Plex     Four-Plex       Fraternity       Sorority    Bed & Breakfast        Townhome

     Single Family Dwelling with Accessory Unit (must also be permitted through P&DS; call 303.441.1880 for more info)


    Complex Name (if applicable)________________________________________________________________________


    PROPERTY OWNER:

    ____________________________________________________________________________________________________
    First Name                          Middle Initial                      Last Name


    ____________________________________________________________________________________________________
    Address                                                   City/State           Zip Code


    ____________________________________________________________________________________________________
    Primary Phone                       Secondary Phone                            E-mail Address


    LOCAL AGENT: A property owner who does not reside in Boulder County shall appoint a person who lives in Boulder County to
    serve as the local agent of the owner. B.R.C. 1981, Section 10-3-14.


    ____________________________________________________________________________________________________
    First Name                          Middle Initial                      Last Name


    ____________________________________________________________________________________________________
    Address                                           City/State            Zip Code


    ____________________________________________________________________________________________________
    Primary Phone                       Secondary Phone                            E-mail Address


    **Correspondence concerning this property should be sent to:            Owner          Agent

    I, the Owner / Agent for the above property, do hereby affirm that information submitted to acquire a rental
    license for the above property is correct.

    Signature: ___________________________________________________________________________Date: __________

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