PAGE 2 OF
5
U:\APPLICATIONS - FORMS\VACATION RENTAL FORMS\VACATION RENTAL CERTIFICATE APPLICATION 6-19-14.docx
PROVIDE THE WEBSITES AND ASSOCIATED LISTING NUMBERS FOR ALL ADVERTISING
PROVIDE THE NUMBER AND LOCATION OF DESIGNATED PARKING SPACES legally available for
Occupants of the vacation rental unit, excluding public parking spaces below.
WILL PETS BE ALLOWED IN THE UNIT? YES NO
IF
YES,
HOW
MANY
PET(S)
.
TYPE
OF
PET(S)
PROPERTY OWNER’S AGREEMENT:
BY signing this AGREEMENT, the Property Owner agrees to use his or her best efforts to
assure that the vacation rental use of the dwelling unit will not disrupt the residential
character of the neighborhood, and will not interfere with the rights of neighboring property
owners to the quiet enjoyment of their residences. Furthermore, the Property Owner
acknowledges that they were provided a copy of Town Ordinance 2009-30 Section 9, Sub-
Section 30-327 for Vacation Rentals.
SIGNATURE:
PRINT NAME:
I HEREBY DECLARE that all information provided in this application is true and correct and,
further, understand that providing false or misleading information on this application may
result in being denied, or the loss thereof, of any license or permit issued by the Town of
Lauderdale-By-The-Sea which was based upon information provided in this application.
APPLICANT’S SIGNATURE:
PRINT NAME:
THE ABOVE PERSON IS KNOWN PERSONALY TO ME OR PRODUCED IDENTIFICATION
SWORN TO AND SUBSCRIBED before me THIS DAY OF
20
NOTARY PUBLIC:
FOR OFFICE USE ONLY
Any other information that this section, or any rules and procedures for implementation of this section that
requires the owner to provide to the Town as part of application for or renewal of a Vacation Rental Certificate,
please indicate below –
APPROVED BY: DATE:
VACATION RENTAL CERTIFICATE FEE: DATE PAID:
