Application_Certificate_of_Occupancy

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					Re-Inspection
1ST 2ND 3RD

Washington Township Housing Office
523 Egg Harbor Road Sewell, NJ 08080 856-589-0520 Ext. 245 www.townshipnj.com

Inspection Date Lock Box

APPLICATION FOR CERTIFICATE OF OCCUPANCY
ADDRESS TO BE INSPECTED: Block CURRENT OWNER: Name: Address:
Email address:

Lot

Qual:

IS DWELLING VACANT?

Yes

No

Phone #:

PROSPECTIVE BUYER / TENANT: Name: Address: REALTORS: Phone #:

Seller's Agent / Telephone Number

Buyer's Agent / Telephone Number

Inspection Type

A COPY OF THE INSPECTION RESULTS WILL BE LEFT AT THE PROPERTY.

□ Resale □ Rental
TYPE OF DWELLING:

□ Annual □ Tenant Change
□ Duplex □ Condo □ Two-Family

Settlement / Occupancy Date:

□ Single Family

□ Mobile Home

□ Twin

□ Apartment

□ Other

Current Owner's Signature OFFICE USE ONLY:

Date

Received

$70 Initial Inspection Fee (Includes 1 Re-Inspection) $50 - each subsequent inspection Check Number/Cash Payable To: Township of Washington

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