APPLICATION FOR RESIDENTIAL RENTAL LICENSE

PROPERTY OWNER INFORMATION

ADDRESS OF RENTAL PROPERTY IN WEST CHICAGO *

TYPE OF RENTAL PROPERTY *

Condominium Townhome Multi-Tenant Building or Complex Single Family House

TYPE OF OWNERSHIP *

Individual LLC/LLP Corporation Trust

You selected the ownership as a Trust. If the owner is a land trust, please upload a certified copy of a trust disclosure including the name and address of each person holding a beneficial interest and/or power of direction therein.

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NAME(S) OF LEGAL OWNER(S) (As Shown on Property Deed) *

First Name Last Name

BIRTH DATE OF OWNER *

Date

MAILING ADDRESS OF OWNER (Other than address of rental property above) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

PRIMARY PHONE NO. OF OWNER *

Please enter a valid phone number.

SECONDARY PHONE NO. OF OWNER *

Please enter a valid phone number.

EMAIL ADDRESS OF OWNER *

example@example.com

NAME OF 24-HOUR EMERGENCY CONTACT *

First Name Last Name

PHONE NO. OF 24-HOUR EMERGENCY CONTACT *

Please enter a valid phone number.

PROPERTY MANAGEMENT & NOTIFICATIONS PREFERENCE

As the applicant, I confirm that the property management of this rental and all its related notifications from the City of West Chicago are hereby named to be in the care of: *

Legal Owner (whose email and mailing addresses are provided above.) Property Manager or Management Company(whoe email and mailing addresses are provided below.)

PROPERTY MANAGER/MANAGEMENT COMPANY INFORMATION

NOTE: In the event that the owner of the rental property resides more than 30 miles outside the corporate limits of the City, the owner shall appoint a managing agent authorized to receive notices and process on behalf of the owner and who has an office or residence within 30 miles of the corporate limits of the City with regular business hours. If applicable, you are required to provide this information below.

Does the legal owner reside farther than 30 miles from the City of West Chicago? *

No Yes

NAME OF PROPERTY MANAGER CONTACT

First Name Last Name

NAME OF PROPERTY MANAGEMENT COMPANY

ADDRESS OF PROPERTY MANAGER/MANAGEMENT COMPANY

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

PHONE NO. OF PROPERTY MANAGER/MANAGEMENT COMPANY

Please enter a valid phone number.

EMAIL OF PROPERTY MANAGER/MANAGEMENT COMPANY

example@example.com

LICENSE FEE SCHEDULE

The license fee shall accompany each application for License. All Rental Licenses expire at the end of EACH calendar year. Rental License fees cannot be prorated. You must plan to renew any Rental License with the City prior to the end of the calendar year. License fees shall be determined by the following schedule:

Single Family, 2 Flats and Townhomes (up to 2 units)	$265.00 per Building
Condominiums	$265.00 per Unit
Multiple Family Buildings (3 units or more)	$265.00 per Building plus $40.00 per Unit

The annual license fee shall include a base license fee as detailed above plus, if applicable, any money owed by the applicant to the City for any purpose whatsoever and any outstanding fees, costs or charges associated with the rental property for which a license is sought. Any partial payments shall first be applied to outstanding debt associated either with the applicant or with the rental property for which a license is sought.

NOTE: If the application and payment for the renewal of any Rental License are not submitted prior to January 1st in any given year, the base license fee shall be increased by an additional twenty (20) percent on the first day of each subsequent month, until such time as a complete license application and the required license fee is paid. In the event that said application, along with the required license fee is not filed as provided herein, said license shall, at the discretion of the City, not be issued.

NO. OF UNITS IN EACH BUILDING *

NO. OF BUILDINGS *

LICENSE FEE *

(No. of Bldgs. x $265.00 + No. of Units (>2) x $40.00)

CONSENT & SIGNATURE OF LEGAL OWNER/APPLICANT

Please read each item below and TYPE your initials in the space provided to confirm your agreement.

(A) The information submitted in this application is an accurate representation of the facts at the date of application. *

(B) I have read and understand Chapter 9, Article XV of the City Code pertaining to the licensing inspection of rental properties, which has been made available to me via the City's website, www.westchicago.org, or I have requested in writing that a hard copy be provided to me. *

(C) I will not violate any of the ordinances of the City. *

(D) I agree to the use of a written lease executed on behalf of the owner and the tenant, which will contain all provisions as outlined in Article XV of the City Code and will be furnished upon request by the City or its inspectors. Furthermore, I will obtain a written application from each tenant prior to adopting any lease. I also agree to provide a copy of a valid lease (one for each unit) at the time of inspection, which includes wording to indicate the tenant's irrevocable consent to allow the City and its inspectors to enter any and all portions of the property for purposes of conducting the inspection. Failure to do so will result in cancellation of the inspection and possible re-inspection fees. *

(E) I will request and the City shall conduct an inspection of my rental property or properties to ensure full compliance with all applicable ordinances. I further understand that it is my responsibility to schedule and obtain approved inspections on an annual basis during the month I am assigned to ensure that rental properties are properly maintained, even if the unit is vacant or for sale. *

(F) I irrevocably consent to the City's and its inspectors' entry upon any and all portions of the licensed rental property for purposes of making the inspections required and/or permitted under this ordinance, including the right to inspect individual dwelling units. *

(G) I irrevocably consent and agree to pay (1) any money owed to the City for any purpose whatsoever and any outstanding fees, costs or charges associated with any rental property in City for which I am the applicant, such as water, garbage, etc.; and (2) all enforcement costs provided for by Chapter 9. Article XV of the City Code. *

(H) I understand that the license for which I am applying expires on December 31 of this and each subsequent year. A renewal application and fee must be submitted prior to that date. If the rental unit is listed for sale at the time of the annual renewal, adequate proof must be provided to the City. *

SIGNATURE

As the legal owner of the property for which I am applying for a license, and by undersigning below, I hereby certify the above information and agree to all terms and conditions outlined in Article XV of the City Code:

Signature of Legal Owner/Applicant *

Clear

Type Full Name of Legal Owner/Applicant *

Date *

Date

RENTAL PROPERTY DEED/PROOF OF TITLE

In order for the rental license to be issued, you are required to provide a copy of the property deed. Please upload it here. Locate a free copy at: www.recorder@dupageco.org/Search.aspx.

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CITY OF WEST CHICAGO