City of Cape Girardeau, Missouri

401 INDEPENDENCE
P.O. BOX 617
CAPE GIRARDEAU, MO 63702
Phone: 573-334-1332 Fax: 573-335-7946

Application by Owner of Real Estate to operate a Boarding House

City of Cape Girardeau Seal
Name ___________________________________________________________________
Location of property ________________________________________________________
Name and adddress of owner of property ________________________________________
________________________________________________________________________
Number of rooms in home _________________________________________
Number of persons occupying rooms ____________________________
Number of persons occupying rooms with
  1. Automobiles _____________________________________________
  2. Motorcycles _____________________________________________
  3. Other forms of motor vehicles _________________________
    4.
Number of off-site parking spaces provided for persons occupying rooms ________________

I AGREE THAT AUTHORIZED PERSONNEL OF THE CITY OF CAPE GIRARDEAU AND STATE OF MISSOURI AT REASONABLE TIMES MAY INSPECT MY PROPERTY FOR PURPOSES OF DETERMINING HEALTH, FIRE, ELECTRIC, PLUMBING AND OTHER FACTORES AFFECTING THE SAFETY AND WELFARE OF THOSE PERSONS WHO OCCUPY THE PREMISES DESCRIBED HEREIN.

I CERTIFY THAT THE FOREGOING ANSWERS ARE TRUE AND CORRECT ACCORDING TO MY BEST INFORMATION AND BELIEF.

__________________________________________
Signature		 _________________
Date

Zoning ___________________________
City Inspector _____________________________________
Finance Department _________________________________

__________________________________________
City Collector		 _________________
Date