Finalize: APPLICATION FOR RENTAL OPERATING LICENSE "*" indicates required fields I. Property Information & Fee DueAddress* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of units in structure*Please enter a number greater than or equal to 1.Number of units being inspected*Please enter a number greater than or equal to 1.Fees Price: $0.00 Fee is $75 per unit being inspected. II. Owner/Property Manager InformationIf owner is not a full-time resident within the borough of Verona and/or lives outside a 15-mile radius of the Borough, the owner is required to enlist the services of a property manager who lives within the stated radius and who will control the work/business affairs of the property owner. Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* III. Owner/Property Manager E-SignatureIf owner is not a full-time resident within the By signing their name(s) below, OWNER/LANDLORD/MANAGER of the property assumes full responsibility for all ordinances pertinent to owning/renting property in the Borough of Verona.Electronic Signature*Please type your full name above to serve as your electronic signature. By signing above, OWNER/LANDLORD/MANAGER of the property assumes full responsibility for all ordinances pertinent to owning/renting property in the Borough of Verona. Any deliberate misstatement upon the form is prosecutable as an unsworn falsification as provided by S4904 of the PA Crimes Code.Total fee collected
