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Smoke Detector Self Inspection Confirmation

  1. Please check your preference for future smoke detector notifications from the City. *
    1. Name of authorized Agent/Manager who performed inspection if different than owner.
    2. Rental Property Address
    3. Use for additional properties
    4. Required
    5. Use for additional properties
    6. Required
    7. Use for additional properties
    8. Required
    9. Use for additional properties
    10. Required
    11. 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.
    13. Leave This Blank:

    14. This field is not part of the form submission.