HOUSING CERTIFICATE OF OCCUPANCY Application

							 Block_ _                   Lot,          _                                              Certificate Number
                                                                                                           ------
                      TOWNSHIP OF PLAINSBORO                        HOUSING CERTIFICATE OF OCCUPANCY


     Ii               641 PLAINSBORO ROAD
                      PLAINSBORO, NJ 08536
                      (609) 799-0909 Ext. 214 Fax (609) 799-0657

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                                                                               Application
                                                                              (CHAPTER 70A-HOUSING CODE)




             Application and fee must be in office 24 hours prior to inspection.
Check One:        [     ]    Single Family / Villa                            [ ]     Condominium
                  [     ]    Townhouse                                        [ ]     Re- Inspection

Please Print:
Property Address                                                                     TT-::=~-----------_
                                                                                       Home
O\\'l1er's Name                                                                        Phone No.
                  --------------------                        ----------
Address - - - - - - - - - - - - - - - - - - - - - - Business No. - - - - - - - - - -



Buyer / Tenant Name                                                                    Phone No.                        _


Seller Realtor Name

                            --------------------------------
Phone No. - - - - - - - - - - - - - - - - - - - - - -Fax No.
- - - - - - - - - - - -

Seller Anomey Name                                  ~                                                                   _


Phone No, - - - - - - - - - - - - - - - - - - - - - Fax Number- - - - - - - - - -

                              [    ]   Rental               [   ]    Resale

An inspection is authorized in accordance with PHC70A-2. of the Plainsboro Township Housing
Code. Correction of any violations will be the owner's responsibility, unless waived in accordance
with PHC70A-2.F.(5).


                                                                    Signed                                              _
                                                                                    ( ) O\\,l1er         ( ) Agent

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 For Office Use:
 Initial Fee $                             _                Initial Inspection:
 [ ] Cash             ] Check No.               _                                                  *Time: - - - - - ­
                                                            Date: - - - - - ­
 Col'd By:                   Date               _
                                                            Re-Inspcction:
 Re-Inspection Fee $                            _
 [ ] Cash             ] Check No.               _           Date:                                  *Time: - - - - - ­
                              .
 Col'd By:                   Date               _
                                                            *Due to the unpredictabi lity of the inspection
 HC-l
 20801
                                                             process, the inspector may be delayed beyond
 Revised 02/01/2008                                          time noted.