HomeMy WebLinkAbout2/27/02 8784
RENTAL PERMIT APPLICATION
Rental Permit #' REN03428
Premises Address · 529 RONALDS ST
Operator's Name and Address ·
CITY OF I0 WA CITY
CHAMBERS AGENCY
800 2ND ST SUITE 500 EAST
CORALVlLLE, IA 52241
THIS APPLICATION VALID FOR PERIOD ENDING ' 10/31/2004
Rooming Units' 0
Dwelling Units' 1
Type 3 Units · 0
Bedrooms · 1
Rental Fee' $66.00
Appli~an}"S~gnature - '
Date Signed
Applicant: Please verify information, make changes if required; sign and date application. Please add
your e-mail address, if applicable.
Received by housing personnel'
E-mail Address
/2.11-~1
Date and Initials
PLEASE RETURN THIS APPLICATION WITH AMOUNT DUE
ren_lttr.rpt