Property Information

Assessor's Parcel Number*

Address or Location of Property*

Number of Existing Houses and ADUs On-Site*

Existing Use(s) On Site*

Owner/Applicant Information

Property Owner(s) of Record*

Applicant's Name (if different than owner)

Applicant's Address (if different than property address)

Phone Number*

Email Address*

Proposed ADU Development

Intended Use of ADU*

-- Select One -- Low-Income Restricted Non-Restricted

Type of ADU Unit*

-- Select One -- Studio One Bedroom Two or More Bedroom

Proposed Gross Floor Area (in Square Feet)*

Amount of Incentive Requesting (in $)*

Authorization

Authorized Digital Signature*

I Authorize as Owner

I Authorize as Applicant

Date*

Note: By checking this box, you are creating a digital signature that is legally binding and equivalent to your handwritten signature under applicable law.