Type of Ownership

Sole Proprietorship LLC Corporation Partnership

Number of Units

Home and Owner Information

Property Owner First Name:*

Property Owner Last Name:*

Property Owner Email

Street Name:*

City:

State:*

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Zip Code:*

Person authorized to schedule inspections and property compliance*

Disclaimer

I declare under penalty of perjury that the foregoing is true and correct to my knowledge. I authorize the City or its employees or agents to conduct an investigation in accordance with Chapter 5.72 of the Hesperia Municipal Code. I also authorize an inspection of the property in accordance with Chapter 5.72 of the Hesperia Municipal Code.