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2. All information provided in this form is subject to Freedom of Information Act requests subject to State law.
4. Property Type

   1. $180 Commercial
   2. $180 Residential
6. Property Owner First Name*
7. Property Owner Last Name*
9. Property Owner Street Address*
11. City*
12. State*
13. Zip Code*
15. Property Owner Phone Number
17. Property Owner Email Address
19. What is your preferred method of contact?*

    1. Email
    2. Phone
    3. USPS Mail
21. Vacant Property Street Address*
23. City*
24. State*
25. Zip Code*
27. Once the online registration is completed, you will be receiving an invoice in the mail for the $180 registration fee within the next 7 to 10 business days.
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field