BOROUGH OF SAYREVILLE APPLICATION FOR RENTAL COMPLIANCE CERTIFICATE Inspection Date and Time: ________________ Certificate                                                                     Date                                                                Owner Information Property Address                                                                                                                     Building Number  _________________       Apartment Number ____________________ Owner’s Name                                                                          Phone                          Address                                                                                                                                   Named on Lease __________________________________________________________ Number of Occupants ___________________  Phone Number _____________________ Dwelling Details Total # of Rooms                       # of Bedrooms                         # of Bathrooms                        Is this a basement apartment? Y / N                  Is this an attic apartment? Y / N Is there any special condition that this department should be made aware of prior to inspection?  Y / N Is so, please specify                                                                                                                  Date                                     Applicant’s signature                                                                     Please arrive 15 minutes prior to the scheduled inspection time. THE FEE FOR THE INITIAL INSPECTION FOR A CERTIFICATE OF RENTAL COMPLIANCE SHALL BE $75.00 AND IF A REINSPECTION IS REQUIRED, A REINSPECTION FEE OF $50.00 SHALL BE REQUIRED FEES MUST BE PAID AT THE TIME OF APPLICATION FILING AND PRIOR TO ANY REINSPECTION. CHECKS, CREDIT CARD OR MONEY ORDER ARE TO BE MADE PAYABLE TO THE BOROUGH OF SAYREVILLE FOR DEPARTMENT USE ONLY: Application processed by:                                                         Type of Payment (Checks, Credit Card, Money Order) check #                    Amount Paid                _____ Additional Comments                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                _