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2. Property Owner Information
4. First Name*
5. Last Name*
6. Business Name, if applicable
8. Address 1*
9. Address 2
11. City*
12. State*
13. Zip*
15. E-mail Address
16. Phone Number (Primary)*
17. Phone Number (Secondary)
19. I will be the primary contact, responsible for all property management and license maintenance business.*

    1. Yes, I am the primary contact.

    1. No, a designated agent will be the primary contact.
21. **If you live more than 50 miles outside of Dubuque's city limits, a designated local agent is required to be on file for any immediate property maintenance issues. Please complete the form linked to the right.**
    When you click the link, it will open in a new window/tab so the information you've entered in this form will not be lost. Simply return to this window/tab to complete and submit this form.
22. Click below to open form:
    Designated Local Agent Form
26. Rental Structure Information
28. Address*
29. City, State*
30. Zip*
32. Definition of Dwelling Unit & Rooming Unit
    Dwelling Unit: A single unit providing complete, independent living facilities for one or more persons, including permanent provisions for living, sleeping, eating, cooking and sanitation. Rooming Unit: Any room or group of rooms forming a single habitable unit occupied or intended to be occupied for sleeping or living, but not for cooking purposes. (Source: International Property Maintenance Code)
33. Number of dwelling units:*
    (i.e. apartments)
34. Number of rooming units:*
    (i.e. dormitories)
36. List the addressing for all units in this structure:*
    For example, a single family home may be: 1234 Main St. A duplex may be: 1234 Main St. & 1234 1/2 Main St. A multifamily may be: 1234 Main St. #101, Unit A, 3A, etc.
38. Are any units owner-occupied?*

    1. Yes
    2. No
39. If so, which unit is owner-occupied?
41. If any unit(s) were vacant, would you accept a Housing Choice Voucher (Section 8)?*

    1. Yes
    2. No
42. If no, why not?
44. Are you interested in receiving more information about the Housing Choice Voucher Program?*

    1. Yes
    2. No
46. Type your name below to certify your application.*
    By entering my name into this e-form, I acknowledge that all information provided is accurate to the best of my knowledge and I am hereby applying for a Rental Property License for the above-described property. I understand that the license will not be officially issued until the unit(s) have been inspected and found to meet the minimum requirements for the City of Dubuque.
48. Please read this information carefully:
    Property owners must notify the Housing Department Permits Clerk within five (5) days of any change of agent or ownership and within thirty (30) days for any change in contact information, including phone number and mailing address. Licensing and/or inspection fees will be invoiced following the receipt of this application. Please contact the Housing & Community Development Department with any questions at (563)589-4231 or housing@cityofdubuque.org.
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50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

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