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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                                                                                                  

                                                                                                                                               

                                                                                                                                               

                                                                                                                                               

                                                                                                                                               

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