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2. 
4. Rental Unit Address:*
5. Type of Dwelling:*
   -- Select One --Single Family UnitTwo Family DwellingMultiple Family
6. Number of Units*
7. Number of Bedrooms per Unit*
   Please specify if the number of bedrooms vary between units in multiple family dwellings.
9. Number of Bedrooms-Main Floor:*
10. Number of Bedrooms-Basement:*
11. Number of Bedrooms-2nd Floor:*
12. Number of Bedrooms-3rd Floor:*
14. PROPERTY OWNER INFORMATION
    SDLRC Rule: 20:69:14

    Owner must live within 100 miles of Vermillion or have a manager that lives within 100 miles. Property managers must be licensed by the State of South Dakota per Chapter 20:69:14.
16. Name:*
17. Email Address:*
18. Phone Number:*
19. Fax Number:
21. Address:*
22. City:*
23. State:*
24. Zip Code:*
26. Is there a property manager?*
    -- Select One --YesNo
28. Property Manager: *
29. Email Address:*
30. Phone Number:*
31. Fax Number:
33. Address:*
34. City:*
35. State:*
36. Zip Code:*
38. Billing Address:*
    -- Select One --The billing address is the same as the owner.The billing address is the same as the property manager.There is a different billing address.
40. Address:*
41. City:*
42. State:*
43. Zip Code:*
45. FEES

    $30.00 per structure plus $15.00 per unit is due upon registration and each year thereafter. (Example: Single Family Dwelling = $45.00 Duplex = $60.00)

47. Acknowledgement of Fees & Inspection*

    Rental Registration approval is contingent upon an initial inspection. All proposed rental units must be inspected by a City of Vermillion Housing Inspector to ensure compliance with the provisions of the Rental Housing Code; the International Property Maintenance Code; the zoning, subdivision, and building ordinances of the City of Vermillion; and the laws of the state of South Dakota. Any occupancy prior to the initial inspection shall be considered a violation of the Rental Housing Code, and the appropriate penalties shall apply. The owner or agent is required to attend this inspection. Registration fees are accessed annually and sent to the person or corporation indicated in the billing portion of this form. Rental Registration bills are sent on or about December 15th and are due by January 15th. Late fees of $5.00 per unit per month are charged for all late payments.

    1. I acknowledge.
49. RENTAL HOUSING ORDINANCE
    Vermillion Municipal Code Chapter 94: Rental Housing Code

    Landlords should be familiar with the City’s Rental Housing Ordinance; If you have any questions regarding rental housing, please contact the Rental Housing Inspector at 605-677-7090.
51. Electronic Signature Agreement*

    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.

    1. I agree.
53. Electronic Signature*
54. Date:*
    Date:
56. FOR OFFICE USE ONLY
58. Approved/Denied
59. Housing Inspector Signature
60. Date
Leave This Blank:


62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit

* indicates a required field