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2. Property Owner Name*
3. Last Name*
5. Property Owner Address*
7. Property Owner Email
8. Property Owner Phone Number*
10. Please check your preference for future smoke detector notifications from the City. *

    1. Mail

    1. Email
12. Agent/Manager Name
    Name of authorized Agent/Manager who performed inspection if different than owner.
14. Street Number*
    Rental Property Address
15. Street Name*
16. Apt #
17. Date of Inspection*
    Date of Inspection
19. Street Number
    Use for additional properties
20. Street Name
21. Apt #
22. Date of Inspection
    Date of Inspection
    Required
24. Street Number
    Use for additional properties
25. Street Name
26. Apt #
27. Date of Inspection
    Date of Inspection
    Required
29. Street Number
    Use for additional properties
30. Street Name
31. Apt #
32. Date of Inspection
    Date of Inspection
    Required
34. Street Number
    Use for additional properties
35. Street Name
36. Apt #
37. Date of Inspection
    Date of Inspection
    Required
39. Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you have inspected all smoke detectors located at the above address(es) and that at the time of the inspection, all smoke detectors required by the City of Storm Lake housing code were properly installed and in good working order.

    1. I Agree
41. Electronic Signature*
42. Signer is:
    -- Select One --OwnerManagerTenant
44. rentals@stormlake.org~712-732-8002
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

* indicates a required field