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I hereby declare the following: I am the property owner for the property described above. I understand and acknowledge that pursuant to Division 3, Subdivision V of Chapter 50 of the Citrus Heights Municipal Code all rental housing properties and rental housing units are subject to routine periodic inspection by the City of Citrus Heights.
I believe that the property noted above is/are exempt from inspection for the following reason(s):
Please attach documentation of routine inspections by a similar governmental agency such as an agency agreement or copy of the last payment voucher. Documentation must be current and must show the rental property address
Provide the address of the unit you occupy within a multiple unit dwelling. Or provide explanation of why this is not a rental unit under CHMC 50-244.
Please attach documentation that the house is owner occupied in the form of a Cable Bill, Phone bill or a Voter Registration.
Please provide the name and contact information for the new owner:
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 may still be required to provide a traditional signature at a later date.
Option to upload any documentation that believe may support your request
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