Calender Year:

Property Owner Name(s):

Owner Mailing Address:

Owner Mailing City State Zip:

Property Owner Phone:

Alternate Phone:

Email Address:

Vacation Rental Address:

Rental Location City State Zip:

Rental Manager Name:
(must reside in Columbia County)

Manager Address:

Manager City State Zip:

Rental Owner Disclaimer

I certify I have read, understand, and agree to comply with City of Rainier, Oregon Ordinance 1080 Regulations for Vacation Rental Dwelling and that the information I have provided is true and accurate to the best of my knowledge. Upon submittal of application, the City will send notice to all neighbors with in 200 feet of the applied for vacation rental. There is a 15 day wait period for neighboring property owners to submit an appeal. You will be notified if the City of Rainier receives an appeal.

I understand this agreement will become null and void when the City of Rainier receives a written termination request.

Authorized Signature:

Today's Date:

NOTICE:
Acceptance of business license application does not certify that applicant has complied with all City Code provisions.